Provider Demographics
NPI:1730357450
Name:KLEMM, MICHAEL STEVEN (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:KLEMM
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N RIVER RD
Mailing Address - Street 2:SUITE 100 QUIGLEY
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1214
Mailing Address - Country:US
Mailing Address - Phone:847-391-8037
Mailing Address - Fax:847-391-8001
Practice Address - Street 1:1150 N RIVER RD
Practice Address - Street 2:SUITE 100 QUIGLEY
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1214
Practice Address - Country:US
Practice Address - Phone:847-391-8037
Practice Address - Fax:847-391-8001
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health