Individual provider Active NPI

Emma Levine

  • Gastroenterology Physician
  • Chicago, IL
National Provider Identifier
1114555059
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036170890 Issued in IL
Practice address
5841 S Maryland Ave # Mc4076
Chicago, IL 60637-1443
Phone
(773) 795-1824
NPI assigned
Mar 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 036170890 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc4076
Chicago, IL 60637-1443

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

Other practice location 1

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 260-9776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230907003343 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 3870957988 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036170890ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Gastroenterology CurrentSince Jul 25, 2023 Accepting new patients
Regents of the University of California Gastroenterology CurrentSince Jul 25, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 25, 2023 Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 25, 2023 Accepting new patients
University of California San Francisco CurrentSince Jul 25, 2023 Accepting new patients

Locations

2001 The Embarcadero
Ofc Of
San Francisco, CA 94143
Phone (628) 224-5503

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1114555059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC4076",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-795-1824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Parnassus Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941432204",
            "country_code": "US",
            "telephone_number": "415-260-9776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "EMMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036170890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.