Provider Demographics
NPI:1255343521
Name:KLEINMAN, MARLON B (MD)
Entity type:Individual
Prefix:DR
First Name:MARLON
Middle Name:B
Last Name:KLEINMAN
Suffix:
Gender:
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 1:2361 PAYSPHERE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60067
Mailing Address - Country:US
Mailing Address - Phone:800-322-9183
Mailing Address - Fax:847-675-3930
Practice Address - Street 1:9300 WAUKEGAN ROAD
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053
Practice Address - Country:US
Practice Address - Phone:847-675-3900
Practice Address - Fax:847-675-3930
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036086753207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF57775Medicare UPIN
IL4438030001Medicare NSC