Provider Demographics
NPI:1528251972
Name:KOCK, EMILY THOMPSON (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:THOMPSON
Last Name:KOCK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:THOMPSON
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:212 E CULLERTON ST
Mailing Address - Street 2:#1002
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4328
Mailing Address - Country:US
Mailing Address - Phone:312-225-3109
Mailing Address - Fax:
Practice Address - Street 1:212 E CULLERTON ST
Practice Address - Street 2:#1002
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4328
Practice Address - Country:US
Practice Address - Phone:312-225-3109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist