Provider Demographics
NPI:1255463337
Name:JOHN KLIMEDIOTIS S.C.
Entity type:Organization
Organization Name:JOHN KLIMEDIOTIS S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KLIMEDIOTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-296-0505
Mailing Address - Street 1:1420 RENAISSANCE DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1330
Mailing Address - Country:US
Mailing Address - Phone:847-296-0505
Mailing Address - Fax:847-827-1037
Practice Address - Street 1:1420 RENAISSANCE DR
Practice Address - Street 2:SUITE 207
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1330
Practice Address - Country:US
Practice Address - Phone:847-296-0505
Practice Address - Fax:847-827-1037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty