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Individual

EMMY HO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1614 E NORRIS DR, OTTAWA, IL 61350-3681
(815) 433-1010
Mailing address
1614 E NORRIS DR, OTTAWA, IL 61350-3681
(815) 433-1010

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
47560020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13804
DEAN HEALTH PLAN HMO
05
1700894474
WI
Enumeration date
08/04/2006
Last updated
01/14/2015
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