Provider Demographics
NPI:1396238119
Name:MAKI, EMMA (ATC)
Entity type:Individual
Prefix:MISS
First Name:EMMA
Middle Name:
Last Name:MAKI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60046-9296
Mailing Address - Country:US
Mailing Address - Phone:773-715-5247
Mailing Address - Fax:
Practice Address - Street 1:2103 MEADOW DR
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:IL
Practice Address - Zip Code:60046-9296
Practice Address - Country:US
Practice Address - Phone:773-715-5247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer