Provider Demographics
NPI:1952411001
Name:KLIOT, MICHEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:
Last Name:KLIOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:676 N SAINT CLAIR ST
Mailing Address - Street 2:DEPARTMENT OF NEUROSURGERY, SUITE 2210
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2927
Mailing Address - Country:US
Mailing Address - Phone:206-979-6218
Mailing Address - Fax:312-695-0225
Practice Address - Street 1:676 N SAINT CLAIR ST
Practice Address - Street 2:DEPARTMENT OF NEUROSURGERY, SUITE 2210
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2927
Practice Address - Country:US
Practice Address - Phone:206-979-6218
Practice Address - Fax:312-695-0225
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00027742207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAF04637Medicare UPIN