Provider Demographics
NPI:1407037492
Name:DR JAMES A KLINE MD PC
Entity type:Organization
Organization Name:DR JAMES A KLINE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-364-8600
Mailing Address - Street 1:10755 WINTERSET DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-1106
Mailing Address - Country:US
Mailing Address - Phone:708-364-8600
Mailing Address - Fax:
Practice Address - Street 1:10755 WINTERSET DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-1106
Practice Address - Country:US
Practice Address - Phone:708-364-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-18
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-056271207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1104845726OtherNATIONAL PROVIDER ID
IL110220031OtherRAILROAD MEDICARE
ILC50947OtherUPIN
IL1627290OtherBLUE CROSS ILLINOIS
IL1627290OtherBLUE CROSS ILLINOIS
IL652740Medicare PIN