Healthcare Provider Details

I. General information

NPI: 1295559052
Provider Name (Legal Business Name): EMILY KAPLAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S NORTHWEST HWY STE 100
PARK RIDGE IL
60068-4237
US

IV. Provider business mailing address

250 S NORTHWEST HWY STE 100
PARK RIDGE IL
60068-4237
US

V. Phone/Fax

Practice location:
  • Phone: 773-631-7898
  • Fax:
Mailing address:
  • Phone: 773-631-7898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: