MEDICARE: ELISE MARIE HOCKER

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1558869313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISE MARIE HOCKER

Provider Business Mailing Address
First Line	:	145 BALDWIN DR
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94526-5101
Country	:	US
Telephone Number	:	310-808-7387
Fax Number	:

Provider Business Practice Location Address
First Line	:	219 W CHICAGO AVE STE 200
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-5600
Country	:	US
Telephone Number	:	832-761-3176
Fax Number	:

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

Provider Enumeration Date	:	01/26/2018
Last Update Date	:	05/23/2024

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