Emerge Medstaffing LLC
Organization Active NPI Emergency Medicine Physician · Chicago Heights, IL
NPI 1780167841 · NPPES record last updated Sep 13, 2018
Key facts
- NPI
- 1780167841
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- EMERGE MEDSTAFFING LLC
- Practice address
- 30 E 15TH St
Chicago Heights, IL 60411-3459 - Phone
- (312) 206-1064
- Fax
- (708) 991-2630
- NPI assigned
- Sep 13, 2018
- Organization subpart
- No
Authorized official
- Name
- Richard Watson, MD
- Title
- President
- Phone
- (312) 206-1064
Other NPIs on the same Medicare enrollment 1
Subparts reporting this organization as parent 1
Practitioners 28
-
Jarrod S Barker, M.D.
-
Nichelle M Bush, APRN FNP CEN
-
Dayle Valerie Davenport, M.D.
-
Matthew John Glowacki, D.O.
-
Amit Gupta, M.D.
-
Iftikhar Khan, MD
-
Michelle Meeks, MD
-
Oanh J Pham, MD
-
Cherian Issac Plamoottil, D.O.
-
Charlette Robinson, DNP, APRN, FNP-C
-
Monica Stevenson, NP
-
Ernest Walter Waintraub, M.D.
-
Richard O Watson, MD
-
Brandon Paul Wisinski, D.O., M.B.A., M.S.
-
Eunice Yoo, MD
-
Briana N Young, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181105001875 | IL | Part B Supplier - Clinic/Group Practice | 8123371341 |
Receives reassigned benefits from 28 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Frankfort, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
30 E 15TH St
Chicago Heights, IL 60411-3459
Mailing address
PO Box 786
Flossmoor, IL 60422-0786
Phone (312) 206-1064
Other providers in Chicago Heights, IL
- Elite Treatment Center
- Elite Treatment Center
- Elite Treatment Center, Inc.
- Elite Treatment Center, Inc.
- Albert Ellis Jr.
- Emergency Care & Health Organization, LTD
- Haidee Rochelle Emile
- Sonja Enge-Gilton
- Rachel E Engram Sims
- Erica Esquivel
All providers in Chicago Heights, IL · Emergency Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.