MEDICARE: DR. JUDITH KNIGHT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	36099130	IL

General Provider Information

NPI Number	:	1306824156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH KNIGHT MD

Provider Business Mailing Address
First Line	:	342 PARK AVE
Second Line	:
City	:	GLENCOE
State	:	IL
Zip	:	60022
Country	:	US
Telephone Number	:	847-242-0700
Fax Number	:	847-242-0700

Provider Business Practice Location Address
First Line	:	342 PARK AVE
Second Line	:
City	:	GLENCOE
State	:	IL
Zip	:	60022
Country	:	US
Telephone Number	:	847-242-0700
Fax Number	:	847-242-0700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	07/08/2007

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