Active NPI
Lisa E Kokoruz, M.A., CCC-SLP
- Speech-Language Pathologist
- McHenry, IL
National Provider Identifier
1669768321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146.005541
- Practice address
- 1800 Hillside LN
McHenry, IL 60051-3657 - Phone
- (847) 308-1184
- NPI assigned
- Jun 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.005541 | IL | Primary |
Addresses
Primary practice location
1800 Hillside LN
McHenry, IL 60051-3657
Mailing address
1800 Hillside LN
McHenry, IL 60051-3657
Phone (847) 308-1184
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
| License | State | Type | Specialty |
|---|---|---|---|
| 146.005541 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308614400000",
"number": "1669768321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 HILLSIDE LN",
"city": "MCHENRY",
"state": "IL",
"postal_code": "600513657",
"telephone_number": "847-308-1184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 HILLSIDE LN",
"city": "MCHENRY",
"state": "IL",
"postal_code": "600513657",
"telephone_number": "847-308-1184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOKORUZ",
"first_name": "LISA",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-21",
"last_updated": "2011-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146.005541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McHenry, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.