Provider Demographics
NPI:1629358841
Name:KNUCHEL, NECIA MARGARET (RD)
Entity Type:Individual
Prefix:MS
First Name:NECIA
Middle Name:MARGARET
Last Name:KNUCHEL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 N CALIFORNIA AVE # 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5105
Mailing Address - Country:US
Mailing Address - Phone:406-539-8542
Mailing Address - Fax:
Practice Address - Street 1:675 W CENTRAL RD STE 100A
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2374
Practice Address - Country:US
Practice Address - Phone:847-392-9191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.005886133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered