Healthcare Provider Details

I. General information

NPI: 1760622724
Provider Name (Legal Business Name): APK CONSULTING INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N STATE PKWY 3A
CHICAGO IL
60610-1676
US

IV. Provider business mailing address

1501 N STATE PKWY 3A
CHICAGO IL
60610-1676
US

V. Phone/Fax

Practice location:
  • Phone: 312-804-5954
  • Fax: 312-787-5532
Mailing address:
  • Phone: 312-804-5954
  • Fax: 312-787-5532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number03637430
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number036037430
License Number StateIL

VIII. Authorized Official

Name: DR. ALBERT PAUL KNOTT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 312-804-5954