1740271964 NPI number — KNAPP MEDICAL CENTER, LTD.

Table of content: JULIA PRICE PT, DPT (NPI 1629809413)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740271964 NPI number — KNAPP MEDICAL CENTER, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KNAPP MEDICAL CENTER, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740271964
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3303 S HALSTED ST
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60608-6705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-890-0800
Provider Business Mailing Address Fax Number:
773-890-5430

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3303 S HALSTED ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60608-6705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-890-0800
Provider Business Practice Location Address Fax Number:
773-890-5430
Provider Enumeration Date:
11/04/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KNAPP
Authorized Official First Name:
KEITH
Authorized Official Middle Name:
CHARLES
Authorized Official Title or Position:
CORP. PRESIDENT
Authorized Official Telephone Number:
773-890-0800

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  036-62820 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)