1578926960 NPI number — EMILY HOLLINGS CARLEY DMD

Table of content: EMILY HOLLINGS CARLEY DMD (NPI 1578926960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578926960 NPI number — EMILY HOLLINGS CARLEY DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARLEY
Provider First Name:
EMILY
Provider Middle Name:
HOLLINGS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOLLINGS
Provider Other First Name:
EMILY
Provider Other Middle Name:
CALHOUN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1578926960
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
561 ELDER LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINNETKA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60093-4103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-557-7705
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2300 LEHIGH AVE STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENVIEW
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60026-1691
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-930-7039
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/01/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  019030629 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)