Individual provider Active NPI

Emily Nicole Cork, M.A., CCC/SLP

  • Speech-Language Pathologist
  • Caledonia, IL
National Provider Identifier
1609395482
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
857566 Issued in IL
Practice address
2311 Randolph St
Caledonia, IL 61011-9321
Phone
(815) 547-1455
NPI assigned
Sep 13, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 857566 IL Primary

Addresses

Primary practice location

2311 Randolph St
Caledonia, IL 61011-9321

Mailing address

3254 Prairie Rd
Belvidere, IL 61008-9707
Phone (815) 742-7507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
857566ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1609395482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3254 PRAIRIE RD",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610089707",
            "telephone_number": "815-742-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 RANDOLPH ST",
            "city": "CALEDONIA",
            "state": "IL",
            "postal_code": "610119321",
            "telephone_number": "815-547-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORK",
        "first_name": "EMILY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "857566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caledonia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.