Provider Demographics
NPI:1609937143
Name:KNAPPE, MICHELE L (NP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:L
Last Name:KNAPPE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9540 MAYFIELD AVE
Mailing Address - Street 2:# 206
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2876
Mailing Address - Country:US
Mailing Address - Phone:708-424-1772
Mailing Address - Fax:
Practice Address - Street 1:1200 MAPLE RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-1439
Practice Address - Country:US
Practice Address - Phone:815-740-7050
Practice Address - Fax:815-740-7923
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041325662207P00000X
IL209-006318363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine