Healthcare Provider Details

I. General information

NPI: 1386565273
Provider Name (Legal Business Name): JEFFREY KLEPEC LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 E OAK ST
MAHOMET IL
61853-2794
US

IV. Provider business mailing address

1204 E OAK ST
MAHOMET IL
61853-2794
US

V. Phone/Fax

Practice location:
  • Phone: 217-530-5608
  • Fax: 309-981-8714
Mailing address:
  • Phone: 217-530-5608
  • Fax: 309-981-8714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1501299559
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: