NPIMap

Organization Active NPI

Michael L Klestinki Acsw & Associates P.C.

  • Clinical Social Worker
  • Libertyville, IL
National Provider Identifier
1093824161
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MICHAEL L KLESTINKI ACSW & ASSOCIATES P.C.
Practice address
1117 S Milwaukee Ave
Forum Square BLDG B Ste 2
Libertyville, IL 60048-3798
Phone
(847) 367-6900
Fax
(847) 816-6447
NPI assigned
Aug 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael L Klestinski, LCSW
Title
President
Phone
(847) 367-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1117 S Milwaukee Ave
Forum Square BLDG B Ste 2
Libertyville, IL 60048-3798

Mailing address

1117 S Milwaukee Ave
Forum Square BLDG B Ste 2
Libertyville, IL 60048-3798
Phone (847) 367-6900

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093824161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 S MILWAUKEE AVE",
            "address_2": "FORUM SQUARE BLDG B STE 2",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483798",
            "telephone_number": "847-367-6900",
            "fax_number": "847-816-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 S MILWAUKEE AVE",
            "address_2": "FORUM SQUARE BLDG B STE 2",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483798",
            "telephone_number": "847-367-6900",
            "fax_number": "847-816-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L KLESTINKI ACSW & ASSOCIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLESTINSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-367-6900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.