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NPI Code Detail

MEDICARE: MS. EMILY MARIE HENDEL CNP, MS

MEDICARE: MS. EMILY MARIE HENDEL CNP, MS
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
1363LF0000XFamily Nurse Practitioner209006434IL

General Provider Information

NPI Number : 1417118613
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EMILY MARIE HENDEL CNP, MS
Provider Business Mailing Address
First Line : 2611 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4519
Country : US
Telephone Number : 773-395-9900
Fax Number :
Provider Business Practice Location Address
First Line : 2611 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4519
Country : US
Telephone Number : 773-395-9900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2008
Last Update Date : 06/19/2008

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