Healthcare Provider Details

I. General information

NPI: 1134085244
Provider Name (Legal Business Name): ANGELA MARIE KLINTWORTH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 N NAPER BLVD STE 200
NAPERVILLE IL
60563-8838
US

IV. Provider business mailing address

1717 N NAPER BLVD STE 200
NAPERVILLE IL
60563-8838
US

V. Phone/Fax

Practice location:
  • Phone: 708-480-2048
  • Fax: 708-480-0710
Mailing address:
  • Phone: 708-480-2048
  • Fax: 708-480-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.013326
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: