MEDICARE: MRS. LAURA VANCE ROCKEY M.S. CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	146006380	IL

General Provider Information

NPI Number	:	1528576857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURA VANCE ROCKEY M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	515 WOOD CREEK DR
Second Line	:
City	:	ISLAND LAKE
State	:	IL
Zip	:	60042-9657
Country	:	US
Telephone Number	:	847-845-0519
Fax Number	:

Provider Business Practice Location Address
First Line	:	2330 N VERDE DR
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-2867
Country	:	US
Telephone Number	:	847-398-4211
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2018
Last Update Date	:	01/22/2018

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