Provider Demographics
NPI:1952868911
Name:RODHEIM, EMILY A
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:RODHEIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2933 N SHERIDAN RD APT 401
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5930
Mailing Address - Country:US
Mailing Address - Phone:224-234-7812
Mailing Address - Fax:
Practice Address - Street 1:2933 N SHERIDAN RD APT 401
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5930
Practice Address - Country:US
Practice Address - Phone:224-234-7812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist