Individual
SANDRA JEAN KNUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1000 N ALLEN ST, ROBINSON, IL 62454-1167
(618) 544-3131
Mailing address
1000 N ALLEN ST, ROBINSON, IL 62454-1114
(618) 544-3131
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036085707
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001732008
BCBS OF ILL
IL
05
—
036085707
—
IL
05
—
200144890
—
IN
Enumeration date
09/13/2005
Last updated
07/21/2014
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