David Knapik

Individual provider Active NPI Speech-Language Pathologist · Delavan, IL

NPI 1417475419 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1417475419
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
146011271 (IL)
Practice address
501 E 2ND St
Delavan, IL 61734-9617
Phone
(630) 329-1239
NPI assigned
Aug 30, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
146011271ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146011271 IL Yes

Addresses

Primary practice location

501 E 2ND St
Delavan, IL 61734-9617

Mailing address

501 E 2ND St
Delavan, IL 61734-9617
Phone (630) 329-1239

Other identifiers

IdentifierTypeStateIssuer
146011271OtherILIDFPR

Other providers in Delavan, IL

All providers in Delavan, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.