Provider Demographics
NPI:1376578492
Name:KNAUER, HOPE E (MD)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:E
Last Name:KNAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703-2403
Mailing Address - Country:US
Mailing Address - Phone:217-528-7541
Mailing Address - Fax:217-528-8962
Practice Address - Street 1:300 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-2003
Practice Address - Country:US
Practice Address - Phone:217-342-4151
Practice Address - Fax:217-347-8955
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036084841207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL347560Medicare PIN
IL2523659OtherBC/BS #
IL406950OtherHEALTHLINK#
IL036084841Medicaid
IL055760OtherHEALTH ALLIANCE #
IL080138773OtherRAILROAD MEDICARE/PALMETTO GBA
ILF54300Medicare UPIN