Active NPI
Philip Knuth, PA-C
- Physician Assistant
- Bolingbrook, IL
National Provider Identifier
1871923334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.004935
- Practice address
- 391 S Bolingbrook Dr
Bolingbrook, IL 60440-3411 - Phone
- (630) 226-1006
- NPI assigned
- Nov 20, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.004935 | IL | Primary |
Addresses
Primary practice location
391 S Bolingbrook Dr
Bolingbrook, IL 60440-3411
Mailing address
1111 S Alpine Rd Ste 504
Rockford, IL 61108-3948
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.004935 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fastrac Medical, P.C. | Past | Accepting new patients | |
| Midwest Emergency Northern Illinois Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Joliet, IL
- NPI 1659517597
-
- Emergency Medicine Physician
- Ottawa, IL
- NPI 1427217504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384905600000",
"number": "1871923334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 S ALPINE RD STE 504",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611083948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "391 S BOLINGBROOK DR",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604403411",
"telephone_number": "630-226-1006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUTH",
"first_name": "PHILIP",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-20",
"last_updated": "2013-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.004935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolingbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.