Individual
BRENDEN MOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2456 N MANGO AVE, CHICAGO, IL 60639-2313
(773) 237-2702
Mailing address
2048 N CALIFORNIA AVE APT 3R, CHICAGO, IL 60647-3974
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.007490
IL
Other
Enumeration date
01/23/2024
Last updated
01/23/2024
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