MEDICARE: DENISE KLIBANOW L.C.P.C.

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
1	101YP2500X	Professional Counselor	180005651	IL

General Provider Information

NPI Number	:	1356562987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE KLIBANOW L.C.P.C.

Provider Business Mailing Address
First Line	:	1 E NORTHWEST HWY STE 201
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-1700
Country	:	US
Telephone Number	:	847-859-9529
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 E NORTHWEST HWY STE 201
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-1700
Country	:	US
Telephone Number	:	847-859-2987
Fax Number	:	773-257-5330

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	06/08/2023

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