Active NPI
Emily Reinwald
- Physician Assistant
- Chicago, IL
National Provider Identifier
1669289005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.010896
- Practice address
- 2073 N Clybourn Ave
Chicago, IL 60614-4003 - Phone
- (773) 665-4016
- Fax
- (773) 360-6200
- NPI assigned
- Dec 17, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.010896 | IL | Primary |
Addresses
Primary practice location
2073 N Clybourn Ave
Chicago, IL 60614-4003
Mailing address
1278 Berkshire LN
Grayslake, IL 60030-4206
Phone (847) 849-0327
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2073 N Clybourn Ave
Chicago, IL 60614-4003
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.010896 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John G Latall MD SC | Current | Accepting new patients |
Locations
2073 N Clybourn Ave
Chicago, IL 60614
Phone (773) 665-4016
Organizations & group practices 1
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.
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- Chicago, IL
- NPI 1134485055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734566400000",
"number": "1669289005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1278 BERKSHIRE LN",
"city": "GRAYSLAKE",
"state": "IL",
"postal_code": "600304206",
"telephone_number": "847-849-0327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2073 N CLYBOURN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606144003",
"telephone_number": "773-665-4016",
"fax_number": "773-360-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REINWALD",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-17",
"last_updated": "2024-12-19",
"certification_date": "2024-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.010896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.