Provider Demographics
NPI:1588926745
Name:KNIGHT, TINA F (PA-C)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:F
Last Name:KNIGHT
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1875 DEMPSTER ST
Mailing Address - Street 2:SUITE 665
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1186
Mailing Address - Country:US
Mailing Address - Phone:847-825-1590
Mailing Address - Fax:847-825-1604
Practice Address - Street 1:1875 DEMPSTER ST
Practice Address - Street 2:SUITE 665
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1186
Practice Address - Country:US
Practice Address - Phone:847-825-1590
Practice Address - Fax:847-825-1604
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
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Provider Licenses
StateLicense IDTaxonomies
IL085.001612363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical