Provider Demographics
NPI:1578991428
Name:CONSULTANTS IN ALLERGY & ASTHMA CARE, LLC
Entity Type:Organization
Organization Name:CONSULTANTS IN ALLERGY & ASTHMA CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER--SOLE
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-432-0200
Mailing Address - Street 1:1160 PARK AVE W
Mailing Address - Street 2:SUITE 3 SOUTH
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2230
Mailing Address - Country:US
Mailing Address - Phone:847-432-0200
Mailing Address - Fax:847-432-0201
Practice Address - Street 1:1160 PARK AVE W
Practice Address - Street 2:SUITE 3 SOUTH
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2230
Practice Address - Country:US
Practice Address - Phone:847-432-0200
Practice Address - Fax:847-432-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036079688207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE58910Medicare UPIN