Penelope A Klestinski in Libertyville - Clinical
Penelope A Klestinski - NPI 1265545628
Penelope A Klestinski is a Clinical in Libertyville, Illinois. Penelope A Klestinski practices all healthcare services and medical treatments related to Clinical. The NPI Number for Penelope A Klestinski is 1265545628. The last update date is 2007-07-08.
Penelope A Klestinski's current location address is 1019 Fairlawn Ave, Libertyville, Illinois. You can contact this provider via phone number 8473676900 and fax number 8478166447. The mailing address for Penelope A Klestinski is 1019 Fairlawn Ave, Libertyville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Penelope A Klestinski |
|---|---|
| Address | 1019 Fairlawn Ave, Libertyville, Illinois |
| Phone Number | 8473676900 |
| Fax Number | 8478166447 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1265545628 |
|---|---|
| Provider Enumeration Date | 2006-08-17 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1019 Fairlawn Ave |
|---|---|
| City | Libertyville |
| State | Illinois (IL) |
| Post Code | 600483031 |
| Phone Number | 8473676900 |
| Fax Number | 8478166447 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique 10-digit identification code assigned to Penelope A Klestinski by the Centers for Medicare & Medicaid Services?
The Penelope A Klestinski has been issued the NPI (National Provider Identifier) 1265545628, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Penelope A Klestinski?
The Penelope A Klestinski is situated at 1019 Fairlawn Ave, in the city of Libertyville, state of IL, with the zip code 600483031.
What is the Penelope A Klestinski's specialty and taxonomy code?
The Penelope A Klestinski's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1265545628 to Penelope A Klestinski?
The Centers for Medicare & Medicaid Services originally issued the 1265545628 to Penelope A Klestinski on 2006-08-17.
When was the information regarding Penelope A Klestinski most recently updated?
The details pertaining to the Penelope A Klestinski, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
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