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NPI Code Detail

MEDICARE: JANE KNOCHE

MEDICARE: JANE KNOCHE
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
1101YM0800XMental Health Counselor180.011460IL

General Provider Information

NPI Number : 1699275313
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE KNOCHE
Provider Business Mailing Address
First Line : 2400 N LAKEVIEW AVE APT 1705
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2739
Country : US
Telephone Number : 708-738-9594
Fax Number :
Provider Business Practice Location Address
First Line : 4611 N RAVENSWOOD AVE STE 105
Second Line :
City : CHICAGO
State : IL
Zip : 60640-7569
Country : US
Telephone Number : 708-738-9594
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2018
Last Update Date : 02/19/2018

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