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NPI Code Detail

MEDICARE: DR. NANCY ELLEN KLEIN DDS

MEDICARE:  DR. NANCY ELLEN KLEIN  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry019020096IL

General Provider Information

NPI Number : 1083617070
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NANCY ELLEN KLEIN DDS
Provider Business Mailing Address
First Line : 1773 RIDGELEE RD
Second Line :
City : HIGHLAND PARK
State : IL
Zip : 60035-4348
Country : US
Telephone Number : 847-831-3311
Fax Number :
Provider Business Practice Location Address
First Line : 711 ORCHARD ST STE 1
Second Line :
City : DEERFIELD
State : IL
Zip : 60015-3107
Country : US
Telephone Number : 847-254-6244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 07/24/2019

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Directions to “ DR. NANCY ELLEN KLEIN DDS” Practice Location

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