Individual
KLEVEN H ISRAELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
925 WEST ST, PERU, IL 61354-2757
(815) 223-3300
(815) 223-3394
Mailing address
200 GOLDENWOOD CT, AURORA, IL 60502-6972
(630) 585-9320
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036083343
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036083343-8
—
IL
Enumeration date
05/17/2006
Last updated
07/13/2009
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