Healthcare Provider Details

I. General information

NPI: 1073564332
Provider Name (Legal Business Name): CATHERINE M KLIMA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 SANTA FE LN
WILLOW SPRINGS IL
60480-1624
US

IV. Provider business mailing address

171 SANTA FE LN
WILLOW SPRINGS IL
60480-1624
US

V. Phone/Fax

Practice location:
  • Phone: 708-425-8900
  • Fax: 708-425-9612
Mailing address:
  • Phone: 630-601-8660
  • Fax: 248-699-7851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149009990
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: