Provider Demographics
NPI:1578677084
Name:KLEEN, YECHIEL (MD)
Entity Type:Individual
Prefix:
First Name:YECHIEL
Middle Name:
Last Name:KLEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 COLDWATER CREEK DR
Mailing Address - Street 2:REHABILITATION HOSPITAL OF WISCONSIN
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-8028
Mailing Address - Country:US
Mailing Address - Phone:262-521-8800
Mailing Address - Fax:
Practice Address - Street 1:1625 COLDWATER CREEK DR
Practice Address - Street 2:REHABILITATION HOSPITAL OF WISCONSIN
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-8028
Practice Address - Country:US
Practice Address - Phone:262-521-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI55750208100000X
CO30858225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
683750640Medicare PIN