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General NPI Number Information
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NPI Number | 1194042614
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Entity Type | Organization
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Legal Business Name | KNODEL ENTERPRISES
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 3936 N CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60634-2732
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Country | US
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Telephone | 224-595-1096
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Fax | 773-685-2416
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Provider Business Mailing Address
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Address Line | 3936 N CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60634-2732
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Country | US
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Telephone | 224-595-1096
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Fax | 773-685-2416
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERICH H KNODEL
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Credential |
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Telephone | 224-595-1096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | 347C00000X
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License Number State | IL
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