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NPI Code Detail

MEDICARE: DORA LEIGH KLINK AUD

MEDICARE:   DORA LEIGH KLINK  AUD
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
1231H00000XAudiologist147001926IL

General Provider Information

NPI Number : 1255058376
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORA LEIGH KLINK AUD
Provider Business Mailing Address
First Line : 313 ELGIN AVE APT 201
Second Line :
City : FOREST PARK
State : IL
Zip : 60130-1654
Country : US
Telephone Number : 731-363-9253
Fax Number :
Provider Business Practice Location Address
First Line : 6905 NORTH AVE
Second Line :
City : OAK PARK
State : IL
Zip : 60302-1041
Country : US
Telephone Number : 708-445-7171
Fax Number : 708-445-2616
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2022
Last Update Date : 10/20/2022

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Directions to “ DORA LEIGH KLINK AUD” Practice Location

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