MEDICARE: EMMA KIRKHAM

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	2084P0800X	Psychiatry Physician	209.033838	IL

General Provider Information

NPI Number	:	1467389411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA KIRKHAM

Provider Business Mailing Address
First Line	:	1631 S GALENA AVE
Second Line	:
City	:	FREEPORT
State	:	IL
Zip	:	61032-2517
Country	:	US
Telephone Number	:	815-391-1000
Fax Number	:	815-720-4952

Provider Business Practice Location Address
First Line	:	1631 S GALENA AVE
Second Line	:
City	:	FREEPORT
State	:	IL
Zip	:	61032-2517
Country	:	US
Telephone Number	:	815-391-1000
Fax Number	:

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

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/06/2026

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Directions to “ EMMA KIRKHAM ” Practice Location

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