Provider Demographics
NPI:1306240841
Name:APPIAGYEI, EMELIA BAASIWAH
Entity type:Individual
Prefix:
First Name:EMELIA
Middle Name:BAASIWAH
Last Name:APPIAGYEI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:O
Other - Last Name:APPIAGYEI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1585 BARRINGTON RD STE 505
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-5020
Mailing Address - Country:US
Mailing Address - Phone:847-278-7633
Mailing Address - Fax:773-994-4610
Practice Address - Street 1:1585 BARRINGTON RD STE 505
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5020
Practice Address - Country:US
Practice Address - Phone:847-278-7633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-13
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209012011363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041319982Medicaid