Provider Demographics
NPI:1417118613
Name:HENDEL, EMILY MARIE (CNP, MS)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:MARIE
Last Name:HENDEL
Suffix:
Gender:F
Credentials:CNP, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 W CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-4519
Mailing Address - Country:US
Mailing Address - Phone:773-395-9900
Mailing Address - Fax:
Practice Address - Street 1:2611 W CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-4519
Practice Address - Country:US
Practice Address - Phone:773-395-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209006434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily