Tom Klaczak, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019035275 Issued in IL

Practice address

850 Busse Hwy
Park Ridge, IL 60068-2302

Phone

(847) 692-6800

NPI assigned

Jun 26, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saint Francis Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Peoria, IL
  • NPI 1023062312
  Medicare reassignment NPD
• Saint Francis Medical Center

  • Home Health Agency
  • Peoria, IL
  • NPI 1346281425
  NPD
• Saint Francis Medical Center

  • Nurse Practitioner
  • Peoria, IL
  • NPI 1962456764
  NPD

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1770328221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 BUSSE HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682302",
            "telephone_number": "847-692-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 BUSSE HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682302",
            "telephone_number": "847-692-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLACZAK",
        "first_name": "TOM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-26",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019035275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas C. Kinnas, M.D.
• Hannah Beth Kinser, DO
• John Kinzer, MD
• Greg Kenneth Kirschner, MD, MPH
• Gary L. Kirshenbaum, M.D.
• Delaney Klarer
• Lynn E Klassman, APN
• Barbara L Klein, MA CCC-SLP
• Erica Lopata Klein, M.D.
• Janice Ruth R. Klich, M.D.

• Dentist in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.