| Michael L Klestinski & Associates, P.c. | |
|
1117 S Milwaukee Ave Forum Square Building B Suite 2 Libertyville IL 60048-3798 | |
| (847) 367-6900 | |
| (847) 816-6447 |
| Full Name | Michael L Klestinski & Associates, P.c. |
|---|---|
| Speciality | Social Worker |
| Location | 1117 S Milwaukee Ave, Libertyville, Illinois |
| Authorized Official Name and Position | Michael L Klestinski (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8473676900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael L Klestinski & Associates, P.c. 1117 S Milwaukee Ave Forum Square Building B Suite 2 Libertyville IL 60048-3798 Ph: (847) 367-6900 | Michael L Klestinski & Associates, P.c. 1117 S Milwaukee Ave Forum Square Building B Suite 2 Libertyville IL 60048-3798 Ph: (847) 367-6900 |
| NPI Number | 1477638948 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 09/24/2015 |
| Medicare PECOS PAC ID | 2466452594 |
|---|---|
| Medicare Enrollment ID | O20070112000461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477638948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Penelope A Klestinski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265545628 PECOS PAC ID: 1254332372 Enrollment ID: I20070116000364 |
| Provider Name | Kenneth J Stall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245344837 PECOS PAC ID: 3678574795 Enrollment ID: I20070116000384 |
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