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NPI Code Detail

MEDICARE: SAMANTHA KLASKE

MEDICARE: SAMANTHA KLASKE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1538905021
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA KLASKE
Provider Business Mailing Address
First Line : 737 W WRIGHTWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2539
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 737 W WRIGHTWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2539
Country : US
Telephone Number : 262-501-0576
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2024
Last Update Date : 01/26/2026

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Directions to “ SAMANTHA KLASKE ” Practice Location

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