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General NPI Number Information
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NPI Number | 1003302159
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Entity Type | Individual
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Provider Name | DAVID EUGENE KLEIN DO
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Gender | Male
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 4600 N RAVENSWOOD AVE
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City | CHICAGO
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State | IL
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Zip | 60640-4510
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Country | US
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Telephone | 773-561-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone | 847-390-5900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084E0001X
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Taxonomy Name | Epilepsy Physician
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License Number | 036.159465
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 5101024326
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036.159465
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License Number State | IL
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