Provider Demographics
NPI:1194971150
Name:KNIPP, ANN S (RD, LDN, CDE)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:S
Last Name:KNIPP
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 E HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-3038
Mailing Address - Country:US
Mailing Address - Phone:847-618-4473
Mailing Address - Fax:847-618-4479
Practice Address - Street 1:27 E HARBOR DR
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-3038
Practice Address - Country:US
Practice Address - Phone:847-618-4473
Practice Address - Fax:847-618-4479
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.000381133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered