Healthcare Provider Details

I. General information

NPI: 1336501824
Provider Name (Legal Business Name): ERNEST EMERY AGACNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 09/06/2025
Certification Date: 09/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 COMMERCE DR STE 333
OAK BROOK IL
60523-8723
US

IV. Provider business mailing address

903 COMMERCE DR STE 333
OAK BROOK IL
60523-8723
US

V. Phone/Fax

Practice location:
  • Phone: 708-246-3627
  • Fax:
Mailing address:
  • Phone: 708-246-3627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number209.013903
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRXN.0106317-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number277-001699
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number209013903
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number289233
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: