Active NPI
Gerald Knighten II
- Counselor
- Western Springs, IL
National Provider Identifier
1255718441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1023 Burlington Ave
Western Springs, IL 60558 - Phone
- (708) 745-5277
- Fax
- (708) 784-9451
- NPI assigned
- Apr 27, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1023 Burlington Ave
Western Springs, IL 60558
Mailing address
1104 Linden Ave
Bellwood, IL 60104-2426
Phone (708) 837-8863
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430092800000",
"number": "1255718441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1104 LINDEN AVE",
"city": "BELLWOOD",
"state": "IL",
"postal_code": "601042426",
"telephone_number": "708-837-8863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1023 BURLINGTON AVE",
"city": "WESTERN SPRINGS",
"state": "IL",
"postal_code": "60558",
"telephone_number": "708-745-5277",
"fax_number": "708-784-9451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNIGHTEN",
"first_name": "GERALD",
"name_suffix": "II",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-04-27",
"last_updated": "2015-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Western Springs, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.