MEDICARE: KENNETH L KLEIN MD

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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	34343	WI
2	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	555027	OTHER	WI	DEAN CARE HMO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881681294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH L KLEIN MD

Provider Business Mailing Address
First Line	:	3005 RIVERSIDE DR
Second Line	:	SUITE 206
City	:	BELOIT
State	:	WI
Zip	:	53511-1500
Country	:	US
Telephone Number	:	608-362-7444
Fax Number	:	608-362-0417

Provider Business Practice Location Address
First Line	:	1969 W HART RD
Second Line	:
City	:	BELOIT
State	:	WI
Zip	:	53511-2230
Country	:	US
Telephone Number	:	608-364-5484
Fax Number	:	608-362-0417

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	07/08/2007

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