MEDICARE: LATISHA EMERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula		IL

General Provider Information

NPI Number	:	1235093923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATISHA EMERY

Provider Business Mailing Address
First Line	:	945 DUNLOP AVE APT 1
Second Line	:
City	:	FOREST PARK
State	:	IL
Zip	:	60130-3046
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	945 DUNLOP AVE APT 1
Second Line	:
City	:	FOREST PARK
State	:	IL
Zip	:	60130-3046
Country	:	US
Telephone Number	:	224-384-0645
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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Directions to “ LATISHA EMERY ” Practice Location

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