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General NPI Number Information
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NPI Number | 1679608822
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Entity Type | Individual
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Provider Name | DAVID ANTHONY KLODD PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/31/2015
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Provider Practice Location Address
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Address Line | 800 AUSTIN AVENUE STE 256 EAST
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City | EVANSTON
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State | IL
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Zip | 60202-3454
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Country | US
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Telephone | 847-674-8761
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Fax | 847-674-8764
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Provider Business Mailing Address
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Address Line | P.O. BOX 43
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City | SKOKIE
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State | IL
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Zip | 60076-0043
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Country | US
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Telephone | 847-674-8761
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Fax | 847-674-8764
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 147-000269
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License Number State | IL
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