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Individual

JUDITH MARIE KNIPPLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5999 NEW WILKE RD BLDG 2, ROLLING MEADOWS, IL 60008-4506
(847) 618-0800
(847) 228-1062
Mailing address
5999 NEW WILKE RD BLDG 2, ROLLING MEADOWS, IL 60008-4506
(847) 618-0800
(847) 228-1062

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-086821
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01627833
BLUE CROSS/BLUE SHIELD
IL
01
036086821
STATE LICENSE
IL
Enumeration date
09/02/2005
Last updated
05/10/2022
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