Provider Demographics
NPI:1851602148
Name:WARD, EMILY V (MB BAO BCH)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:V
Last Name:WARD
Suffix:
Gender:F
Credentials:MB BAO BCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N MCCLURG CT
Mailing Address - Street 2:3006
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4323
Mailing Address - Country:US
Mailing Address - Phone:313-282-7950
Mailing Address - Fax:
Practice Address - Street 1:400 N MCCLURG CT
Practice Address - Street 2:3006
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4323
Practice Address - Country:US
Practice Address - Phone:313-282-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ2909260552085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology