Healthcare Provider Details

I. General information

NPI: 1053863647
Provider Name (Legal Business Name): SHANNON HOCK LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2016
Last Update Date: 01/25/2025
Certification Date: 01/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N MICHIGAN AVE SUITE 1530
CHICAGO IL
60611-3777
US

IV. Provider business mailing address

500 N MICHIGAN AVE STE 1400
CHICAGO IL
60611-3759
US

V. Phone/Fax

Practice location:
  • Phone: 847-868-3435
  • Fax:
Mailing address:
  • Phone: 847-868-3435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180014630
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178012379
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180014630
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: