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NPI Code Detail

MEDICARE: MR. SANFORD I KNIGHT D.P.M.

MEDICARE:  MR. SANFORD I KNIGHT  D.P.M.
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
1213E00000XPodiatrist07000826AIN
2213E00000XPodiatrist016-004716IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
8480025164OTHERILRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000224020OTHERINANTHEM BCBS INDIANA
34840180001OTHERINDMERC
401628296OTHERILBCBS OF ILLINOIS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6000000224021OTHERINANTHEM BCBS INDIANA
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
94856050000OTHERMIBCBS OF MICHIGAN

General Provider Information

NPI Number : 1518901032
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SANFORD I KNIGHT D.P.M.
Provider Business Mailing Address
First Line : 434 WOODLAWN AVE
Second Line :
City : GLENCOE
State : IL
Zip : 60022-2124
Country : US
Telephone Number : 847-612-4729
Fax Number : 847-835-8003
Provider Business Practice Location Address
First Line : 434 WOODLAWN AVE
Second Line :
City : GLENCOE
State : IL
Zip : 60022-2124
Country : US
Telephone Number : 847-612-4729
Fax Number : 847-835-8003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 02/24/2016

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Directions to “ MR. SANFORD I KNIGHT D.P.M.” Practice Location

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