Provider Demographics
NPI:1700392024
Name:KNOP, SANDRA LEE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEE
Last Name:KNOP
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:LEE
Other - Last Name:SLATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23210 CALS CT
Mailing Address - Street 2:
Mailing Address - City:HARVARD
Mailing Address - State:IL
Mailing Address - Zip Code:60033-1500
Mailing Address - Country:US
Mailing Address - Phone:815-245-7911
Mailing Address - Fax:
Practice Address - Street 1:1200 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:HARVARD
Practice Address - State:IL
Practice Address - Zip Code:60033-1730
Practice Address - Country:US
Practice Address - Phone:815-943-6464
Practice Address - Fax:815-943-7495
Is Sole Proprietor?:No
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.000684235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist