Provider Demographics
NPI:1407916661
Name:KLING, PAUL S (OD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:S
Last Name:KLING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13355 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-6487
Mailing Address - Country:US
Mailing Address - Phone:630-257-0251
Mailing Address - Fax:
Practice Address - Street 1:7601 S CICERO AVE
Practice Address - Street 2:FORD CITY MALL
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-1022
Practice Address - Country:US
Practice Address - Phone:773-582-8030
Practice Address - Fax:773-582-9396
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-00830152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL579270040Medicare PIN
ILU156814Medicare UPIN