Provider Demographics
NPI:1710789250
Name:DIAZ, EMMA DENISE
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:DENISE
Last Name:DIAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:DENISE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4326 N ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-1486
Mailing Address - Country:US
Mailing Address - Phone:312-722-9345
Mailing Address - Fax:312-722-9345
Practice Address - Street 1:4326 N ALBANY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-1486
Practice Address - Country:US
Practice Address - Phone:312-722-9345
Practice Address - Fax:312-722-9345
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker