Individual provider Active NPI

Eileen Duggan Klinkert, D.T.

  • Developmental Therapist
  • Palos Park, IL
National Provider Identifier
1982815791
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
License
ED20770698P Issued in IL
Practice address
8444 W 116TH St
Palos Park, IL 60464-1021
Phone
(708) 448-6408
Fax
(773) 535-6611
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X ED20770698P IL Primary

Addresses

Primary practice location

8444 W 116TH St
Palos Park, IL 60464-1021

Mailing address

8444 W 116TH St
Palos Park, IL 60464-1021
Phone (708) 448-6408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ED20770698PILMDDevelopmental Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982815791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8444 W 116TH ST",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641021",
            "telephone_number": "708-448-6408",
            "fax_number": "773-535-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8444 W 116TH ST",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641021",
            "telephone_number": "708-448-6408",
            "fax_number": "773-535-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINKERT",
        "first_name": "EILEEN",
        "middle_name": "DUGGAN",
        "credential": "D.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IL",
            "license": "ED20770698P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.