Emily Bursuck
Individual provider Active NPI Contractor · Chicago, IL
NPI 1811265945 · NPPES record last updated Dec 4, 2011
Key facts
- NPI
- 1811265945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 3901 N Hoyne Ave Apt 1
Chicago, IL 60618-3921 - Phone
- (815) 353-2483
- NPI assigned
- Dec 4, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | IL | Yes |
Addresses
Primary practice location
3901 N Hoyne Ave Apt 1
Chicago, IL 60618-3921
Mailing address
3901 N Hoyne Ave Apt 1
Chicago, IL 60618-3921
Phone (815) 353-2483
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.