Individual provider Active NPI

Emily Custer

  • Geriatric Medicine (Internal Medicine) Physician
  • Chicago, IL
National Provider Identifier
1174218846
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
0361797777 Issued in IL
Practice address
1725 W Harrison St Ste 10
Chicago, IL 60612-3849
Phone
(312) 942-7030
NPI assigned
Apr 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X HS000240L PA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 0361797777 IL Primary

Addresses

Primary practice location

1725 W Harrison St Ste 10
Chicago, IL 60612-3849

Mailing address

1725 W Harrison St Ste 10
Chicago, IL 60612-3849
Phone (312) 942-7030

Other practice location 1

833 Chestnut St Ste 220
Philadelphia, PA 19107-4405
Phone (215) 955-8465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630001741 PA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9032578539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0361797777ILMDGeriatric Medicine (Internal Medicine) Physician
HS000240LPAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1174218846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 10",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123849",
            "telephone_number": "312-942-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 10",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123849",
            "telephone_number": "312-942-7030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 Chestnut St Ste 220",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074405",
            "country_code": "US",
            "telephone_number": "215-955-8465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSTER",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "HS000240L",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "0361797777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.