Organization Active NPI

Michael L Klestinski & Associates, P.C.

  • Social Worker
  • Libertyville, IL
National Provider Identifier
1477638948
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
MICHAEL L KLESTINSKI & ASSOCIATES, P.C.
Practice address
1117 S Milwaukee Ave
Forum Square Building B Suite 2
Libertyville, IL 60048-3798
Phone
(847) 367-6900
Fax
(847) 816-6447
NPI assigned
Oct 25, 2006
Last updated
Sep 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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
Licensed Clinical Social Worker
Phone
(847) 367-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU Primary

Addresses

Primary practice location

1117 S Milwaukee Ave
Forum Square Building B Suite 2
Libertyville, IL 60048-3798

Mailing address

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

National Provider Directory

National Provider Directory

Locations

68 Ambrogio Dr
Ste 101
Gurnee, IL 60031
Phone (847) 662-5588

1117 S Milwaukee Ave
Ste B2
Libertyville, IL 60048
Phone (847) 204-6998

Practitioners & affiliated clinicians

Practitioners 4

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": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443052800000",
    "number": "1477638948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 S MILWAUKEE AVE",
            "address_2": "FORUM SQUARE BUILDING B SUITE 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 BUILDING B SUITE 2",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483798",
            "telephone_number": "847-367-6900",
            "fax_number": "847-816-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L KLESTINSKI & ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2015-09-24",
        "status": "A",
        "authorized_official_last_name": "KLESTINSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "847-367-6900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "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 Sep 24, 2015; 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.