Healthcare Provider Details

I. General information

NPI: 1700609484
Provider Name (Legal Business Name): KNOWN CHICAGO SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 09/02/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 QUAIL RIDGE DR
WESTMONT IL
60559-6145
US

IV. Provider business mailing address

460 QUAIL RIDGE DR
WESTMONT IL
60559-6145
US

V. Phone/Fax

Practice location:
  • Phone: 630-986-2800
  • Fax:
Mailing address:
  • Phone: 630-986-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080B0002X
TaxonomyPediatric Obesity Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRITTA REIERSON
Title or Position: CMO
Credential: MD
Phone: 315-216-2910