Individual
EMILEE JO BOCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
305 E JOE DR, AMBOY, IL 61310
(815) 857-3044
(815) 857-2010
Mailing address
305 E JOE DR, AMBOY, IL 61310
(815) 857-3044
(815) 857-2010
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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