Provider Demographics
NPI:1740845585
Name:KLEEFIELD, PHILLIPE (MA)
Entity type:Individual
Prefix:
First Name:PHILLIPE
Middle Name:
Last Name:KLEEFIELD
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 N SHERIDAN RD APT 19F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-1765
Mailing Address - Country:US
Mailing Address - Phone:646-299-6781
Mailing Address - Fax:
Practice Address - Street 1:600 S WASHINGTON ST STE 105
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6665
Practice Address - Country:US
Practice Address - Phone:630-206-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist