Provider Demographics
NPI:1871689737
Name:KNOOP, STEWART C JR (OD)
Entity Type:Individual
Prefix:DR
First Name:STEWART
Middle Name:C
Last Name:KNOOP
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9285 APRIL CT
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-8327
Mailing Address - Country:US
Mailing Address - Phone:312-405-9302
Mailing Address - Fax:
Practice Address - Street 1:16205 HARLEM AVE STE B
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1682
Practice Address - Country:US
Practice Address - Phone:708-614-9301
Practice Address - Fax:708-614-9316
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist