Provider Demographics
NPI:1154734853
Name:WORRINGER, EMMA
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:WORRINGER
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 1:34 HAVERHILL ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2884
Mailing Address - Country:US
Mailing Address - Phone:978-686-0900
Mailing Address - Fax:
Practice Address - Street 1:3030 N MOBILE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4041
Practice Address - Country:US
Practice Address - Phone:773-622-5679
Practice Address - Fax:773-622-5814
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA260196207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine