Provider Demographics
NPI:1518142488
Name:ADINA KLEIMAN, PHD, LTD
Entity Type:Organization
Organization Name:ADINA KLEIMAN, PHD, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADINA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KLEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-256-0055
Mailing Address - Street 1:444 SKOKIE BLVD
Mailing Address - Street 2:# (SUITE) 340
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091
Mailing Address - Country:US
Mailing Address - Phone:847-256-0055
Mailing Address - Fax:847-853-9526
Practice Address - Street 1:444 SKOKIE BLVD
Practice Address - Street 2:SUITE 340
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091
Practice Address - Country:US
Practice Address - Phone:847-256-0055
Practice Address - Fax:847-853-9526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071001880103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01673019OtherBCBS
ILR17778Medicare UPIN
IL01673019OtherBCBS