Healthcare Provider Details

I. General information

NPI: 1124200928
Provider Name (Legal Business Name): KNECHT CHIROPRACTIC CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2007
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3444 N HALSTED ST
CHICAGO IL
60657-2424
US

IV. Provider business mailing address

3444 N HALSTED ST
CHICAGO IL
60657-2424
US

V. Phone/Fax

Practice location:
  • Phone: 773-525-9100
  • Fax: 773-525-9105
Mailing address:
  • Phone: 773-525-9100
  • Fax: 773-525-9105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. ANDREW T. KNECHT
Title or Position: PRESIDENT
Credential: D.C.
Phone: 773-525-9100