Provider Demographics
NPI:1043214570
Name:KNOWSKI, LINDA M (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:M
Last Name:KNOWSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6968 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60707-4414
Mailing Address - Country:US
Mailing Address - Phone:773-385-9432
Mailing Address - Fax:773-767-3944
Practice Address - Street 1:6968 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60707-4414
Practice Address - Country:US
Practice Address - Phone:773-385-9432
Practice Address - Fax:776-767-3944
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
IL038007121111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01682497OtherBCBS PROVIDER #
IL038007121OtherLICENSE NUMBER
IL01682497OtherBCBS PROVIDER #
ILK29920Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL NUMBE