MEDICARE: EMMA CORNWELL

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	225100000X	Physical Therapist	2026023162	MO

General Provider Information

NPI Number	:	1790622165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA CORNWELL

Provider Business Mailing Address
First Line	:	2122 YORK RD STE 300
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1925
Country	:	US
Telephone Number	:	630-575-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	4029 MILL ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3008
Country	:	US
Telephone Number	:	816-285-0022
Fax Number	:	816-897-0189

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

Provider Enumeration Date	:	05/02/2026
Last Update Date	:	06/08/2026

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Directions to “ EMMA CORNWELL ” Practice Location

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