MEDICARE: MRS. ANGELA NOEL KNISPEL M.S. CCC-SLP

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	235Z00000X	Speech-Language Pathologist	146006057	IL

General Provider Information

NPI Number	:	1447388319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA NOEL KNISPEL M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	14925 KILBOURNE AVE
Second Line	:
City	:	MIDLOTHIAN
State	:	IL
Zip	:	60445-3233
Country	:	US
Telephone Number	:	708-261-2431
Fax Number	:

Provider Business Practice Location Address
First Line	:	1620 N LASALLE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-6005
Country	:	US
Telephone Number	:	312-943-3600
Fax Number	:	866-410-9192

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	05/04/2011

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Directions to “ MRS. ANGELA NOEL KNISPEL M.S. CCC-SLP” Practice Location

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