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Individual
EMILEE JO BOCKER
Active
Individual
EMILEE JO BOCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036.134064
IL
207Q00000X
Family Medicine Physician
Primary
036.134064
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036134064
—
IL
01
—
F400148570
MEDICARE-KSB MED GROUP
IL
01
—
F400168653
MEDICARE-KATHERINE SHAW BETHEA HOSPITAL
IL
Enumeration date
06/07/2011
Last updated
08/22/2018
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