MEDICARE: MR. MICHAEL WARREN KLOBNAK JR. ATC

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	2255A2300X	Athletic Trainer	96002160	IL

General Provider Information

NPI Number	:	1467476366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL WARREN KLOBNAK JR. ATC

Provider Business Mailing Address
First Line	:	2578 PORTAGE AVE
Second Line	:
City	:	WAUCONDA
State	:	IL
Zip	:	60084-5031
Country	:	US
Telephone Number	:	847-526-3103
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 CHURCH ST
Second Line	:
City	:	LAKE ZURICH
State	:	IL
Zip	:	60047-1553
Country	:	US
Telephone Number	:	847-540-4797
Fax Number	:

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	05/07/2008

Similar Medicare Providers

1497187405 — LAURA ANN RIERSON MOT, OTR/L
Practice Location Address:

300 CHURCH ST
LAKE ZURICH, IL
60047-1553

Practice Phone: 309-212-1831
Practice Fax:

1760373609 — KATHLEEN TKOLETZ LAT, ATC
Practice Location Address:

300 CHURCH ST
LAKE ZURICH, IL
60047-1553

Practice Phone: 847-540-4084
Practice Fax:

1609869395 — DR. ANNA BEDROSSIAN O.D.
Practice Location Address:

42002 FOX FARM RD. #100
BIG BEAR LAKE, CA
92315-1553

Practice Phone: 909-866-8002
Practice Fax: 909-866-8023

1528020955 — MICHAEL S PETERSON O.D.
Practice Location Address:

1553 E 3080 S
SALT LAKE CITY, UT
84106-3419

Practice Phone: 801-879-8721
Practice Fax:

1942478540 — JANNA HARTLE LLC
Practice Location Address:

1553 STONEMOOR CIR
SALT LAKE CITY, UT
84121-2515

Practice Phone: 801-274-1447
Practice Fax: 801-273-0775

1942437058 — MICHAEL S PETERSON, OD, PC
Practice Location Address:

1553 GREGSON AVE
SALT LAKE CITY, UT
84106-3419

Practice Phone: 801-879-8721
Practice Fax:

Directions to “ MR. MICHAEL WARREN KLOBNAK JR. ATC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.