Provider Demographics
NPI:1164306619
Name:WEBER, EMMA LEE (BA)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:LEE
Last Name:WEBER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 N KENMORE AVE APT 412
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-5020
Mailing Address - Country:US
Mailing Address - Phone:989-975-9208
Mailing Address - Fax:
Practice Address - Street 1:1580 N NORTHWEST HWY STE 120
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1470
Practice Address - Country:US
Practice Address - Phone:847-220-4977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor