Provider Demographics
NPI:1568230761
Name:LANG, EMILY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8590 TULLAMORE DR
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60487-4771
Mailing Address - Country:US
Mailing Address - Phone:815-474-8242
Mailing Address - Fax:
Practice Address - Street 1:19070 EVERETT BLVD
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-2018
Practice Address - Country:US
Practice Address - Phone:708-575-9795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.029029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily