MEDICARE: JOEL STEVEN KLEIN M.D.

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	207K00000X	Allergy & Immunology Physician	036079688	IL

General Provider Information

NPI Number	:	1770566820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL STEVEN KLEIN M.D.

Provider Business Mailing Address
First Line	:	1160 PARK AVE W
Second Line	:	SUITE 3 SOUTH
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-2230
Country	:	US
Telephone Number	:	847-432-0200
Fax Number	:	847-432-0201

Provider Business Practice Location Address
First Line	:	1160 PARK AVE W
Second Line	:	SUITE 3 SOUTH
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-2230
Country	:	US
Telephone Number	:	847-432-0200
Fax Number	:	847-432-0201

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	12/20/2021

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