Provider Demographics
NPI:1417475419
Name:KNAPIK, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:KNAPIK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DELAVAN
Mailing Address - State:IL
Mailing Address - Zip Code:61734-9617
Mailing Address - Country:US
Mailing Address - Phone:630-329-1239
Mailing Address - Fax:
Practice Address - Street 1:501 E 2ND ST
Practice Address - Street 2:
Practice Address - City:DELAVAN
Practice Address - State:IL
Practice Address - Zip Code:61734-9617
Practice Address - Country:US
Practice Address - Phone:630-329-1239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146011271235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146011271OtherIDFPR