Healthcare Provider Details

I. General information

NPI: 1629273834
Provider Name (Legal Business Name): KAREN A DECOCKER DNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN ANN SANDOCK

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 JORIE BLVD STE 300
OAK BROOK IL
60523-2219
US

IV. Provider business mailing address

8000 WARREN WOODS RD LOT 68
THREE OAKS MI
49128-9573
US

V. Phone/Fax

Practice location:
  • Phone: 630-974-6602
  • Fax: 630-487-2411
Mailing address:
  • Phone: 574-220-4676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277.003915
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: