Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 209.013903 | IL |
N | 363LG0600X | Nurse Practitioner - Gerontology | 209013903 | IL |
NPI | 1336501824 |
---|---|
Provider Name | Mr. Ernest John Emery |
First Address | Naperville, IL 60540-7430 |
Second Address | Naperville, IL 60540-7430 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2016 |
Last Update Date | 01/08/2016 |