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Individual
MR. JEROME J KLINKNER
Active
Individual
MR. JEROME J KLINKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-007838
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K20147
MEDICARE, PROVIDER ID, PROVIDER IN A GROUP
IL
Enumeration date
11/18/2008
Last updated
10/02/2019
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