Provider Demographics
NPI:1972306801
Name:KNOX, DESIRE H
Entity type:Individual
Prefix:
First Name:DESIRE
Middle Name:H
Last Name:KNOX
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16140 HERMITAGE AVE
Mailing Address - Street 2:
Mailing Address - City:MARKHAM
Mailing Address - State:IL
Mailing Address - Zip Code:60428-4940
Mailing Address - Country:US
Mailing Address - Phone:708-916-3675
Mailing Address - Fax:
Practice Address - Street 1:11755 SOUTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1015
Practice Address - Country:US
Practice Address - Phone:708-586-4239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician