Provider Demographics
NPI:1558707877
Name:HINCHCLIFF, EMILY MOSS (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MOSS
Last Name:HINCHCLIFF
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 1:250 E SUPERIOR ST STE 4-420
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2914
Mailing Address - Country:US
Mailing Address - Phone:312-695-0990
Mailing Address - Fax:312-472-4784
Practice Address - Street 1:250 E SUPERIOR ST STE 4-420
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2914
Practice Address - Country:US
Practice Address - Phone:312-695-0990
Practice Address - Fax:312-472-4784
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036156284207VX0201X
TXS1127207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX398694501Medicaid
TX398694502Medicaid