# EMERALD NEURO-RECOVER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508334814
- **Authorized official:** MARGARET G DUNTEMAN CREDENTIALING DEPT. (BILLING AGENT)
- **Authorized official phone:** (630) 770-3800

## Contact information

- **Practice address:** 12265 HANCOCK ST STE 42, CARMEL, IN 46032-5801
- **Practice address phone:** (317) 606-8778
- **Practice address fax:** (317) 740-0534
- **Mailing address:** 12265 HANCOCK ST STE 42, CARMEL, IN 46032-5801
- **Mailing address phone:** (317) 606-8778
- **Mailing address fax:** (317) 740-0534

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/05/2018
- **Last updated:** 09/25/2019