Individual
POLLY M. KNOWLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
2202 HARLEM RD, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 654-5342
Mailing address
1100 SOUTHFIELD DR, STE 1370, PLAINFIELD, IN 46168-4300
(815) 877-4848
(815) 654-5342
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209-003803
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430074175
RAILROAD MEDICARE
—
Enumeration date
08/27/2006
Last updated
09/22/2016
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