Brenden Mock

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

242.007490 Issued in IL

Practice address

2456 N Mango Ave
Chicago, IL 60639-2313

Phone

(773) 237-2702

NPI assigned

Jan 23, 2024

Last updated

Jan 23, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Horizon Science Academy-Belmont

  • Local Education Agency (LEA)
  • Chicago, IL
  • NPI 1629603220
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1417718768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2048 N CALIFORNIA AVE APT 3R",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2456 N MANGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392313",
            "telephone_number": "773-237-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "BRENDEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.007490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dena Mocabee
• Mehmet Cem Mocan, M.D.
• Ebony Lissa Mocanu
• Julio Mocellin Bernardi, MD
• Sima Moceri, MS, OTR/L
• Emily Mock, OTD
• Jane Mockaitis, RD
• Aeleah Lane Mockler, DNP, CRNA
• Nancy Moctezuma-Lopez
• Modarai, D.O., S.C. (Aviator Care)

• Speech-Language Pathologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.