{
"Npi": {
"NPI": "1649915034",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VERRAN",
"FirstName": "EMILIE",
"MiddleName": "MARGARET",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DO",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2650 RIDGE AVE.",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EVANSTON",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60201-1718",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "475-702-0408",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3329 75TH STREET, ENDEAVOR HEALTH MEDICAL GROUP",
"SecondLinePracticeLocationAddress": "SUITE 202",
"PracticeLocationAddressCityName": "WOODRIDGE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60517",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-646-6750",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/01/2022",
"LastUpdateDate": "08/07/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "125.079358",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "036173532",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}