Healthcare Provider Details

I. General information

NPI: 1588421218
Provider Name (Legal Business Name): EMMA C PIRE APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/29/2024
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 N SAINT CLAIR ST STE 650
CHICAGO IL
60611-2929
US

IV. Provider business mailing address

676 N SAINT CLAIR ST STE 650
CHICAGO IL
60611-2929
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-3800
  • Fax: 312-695-3644
Mailing address:
  • Phone: 312-695-3800
  • Fax: 312-695-3644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209033683
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number209033683
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN301754
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041595548
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: