Provider Demographics
NPI:1093059438
Name:KLEINDL, DON III (AA, BC-HIS)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:
Last Name:KLEINDL
Suffix:III
Gender:M
Credentials:AA, BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12135 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:IL
Mailing Address - Zip Code:61011-9110
Mailing Address - Country:US
Mailing Address - Phone:815-298-5559
Mailing Address - Fax:
Practice Address - Street 1:805 E STATE ST
Practice Address - Street 2:
Practice Address - City:CHERRY VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61016-9363
Practice Address - Country:US
Practice Address - Phone:815-298-5559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3060237700000X
WI1363237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist