Individual
DR. KRISTIN W HOUSEKNECHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
614 W MONROE ST, CHICAGO, IL 60661-3654
(312) 258-0700
Mailing address
1074 W TAYLOR ST UNIT 319, CHICAGO, IL 60607-4336
(813) 495-2785
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
036.142542
IL
208D00000X
General Practice Physician
01077086A
IN
208D00000X
General Practice Physician
ME108909
FL
390200000X
Student in an Organized Health Care Education/Training Program
TRN14997
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001052783
ANTHEM
IN
05
—
201398420
—
IN
Enumeration date
06/09/2010
Last updated
01/24/2025
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