Provider Demographics
NPI:1598457863
Name:PARKER, EMMA ELIZABETH (BA)
Entity Type:Individual
Prefix:MS
First Name:EMMA
Middle Name:ELIZABETH
Last Name:PARKER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1113 S MILWAUKEE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3759
Mailing Address - Country:US
Mailing Address - Phone:847-748-0341
Mailing Address - Fax:847-748-0341
Practice Address - Street 1:1113 S MILWAUKEE AVE STE 104
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3759
Practice Address - Country:US
Practice Address - Phone:847-748-0341
Practice Address - Fax:847-748-0341
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health