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General NPI Number Information
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NPI Number | 1487388179
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Entity Type | Individual
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Provider Name | MARGARET MARY KNOLL PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 2400 N SHEFFIELD AVE
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City | CHICAGO
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State | IL
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Zip | 60614-3936
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Country | US
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Telephone | 773-389-2202
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Fax |
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Provider Business Mailing Address
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Address Line | 8521 HARBOUR TOWNE LN
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City | BLOOMINGTON
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State | IL
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Zip | 61705-5575
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Country | US
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Telephone | 309-824-6696
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 070026732
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License Number State | IL
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