1740481472 NPI number — HEIKE CHRISTIANE KNORPP MD

Table of content: HEIKE CHRISTIANE KNORPP MD (NPI 1740481472)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740481472 NPI number — HEIKE CHRISTIANE KNORPP MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNORPP
Provider First Name:
HEIKE
Provider Middle Name:
CHRISTIANE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1740481472
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 443
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEDFORD PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60499-0443
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-831-8282
Provider Business Mailing Address Fax Number:
773-714-1229

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9330 W HIGGINS RD
Provider Second Line Business Practice Location Address:
STE 1100
Provider Business Practice Location Address City Name:
ROSMONT
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60018-4962
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-355-5300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/30/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  036124356 , 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)