Provider Demographics
NPI:1487832069
Name:HOAG, EMILY MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:MARY
Last Name:HOAG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N CLINTON ST
Mailing Address - Street 2:16
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-2386
Mailing Address - Country:US
Mailing Address - Phone:312-876-1006
Mailing Address - Fax:
Practice Address - Street 1:118 N CLINTON ST
Practice Address - Street 2:16
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-2386
Practice Address - Country:US
Practice Address - Phone:312-876-1006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0756322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry