Individual
DAVID A KLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7 BLANCHARD CIR, WHEATON, IL 60189-2037
(630) 668-0833
(630) 668-7685
Mailing address
7 BLANCHARD CIR, WHEATON, IL 60189-2037
(630) 668-0833
(630) 668-7685
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036092501
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036092501
MEDICAID
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147258
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
02/15/2006
Last updated
11/14/2013
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