Provider Demographics
NPI:1235409335
Name:KLEISS, LINDA K (ND, CFNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:KLEISS
Suffix:
Gender:
Credentials:ND, CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:27790 W HIGHWAY 22
Practice Address - Street 2:SUITE 37
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2340
Practice Address - Country:US
Practice Address - Phone:847-382-4406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-199717363L00000X
IL277-000869363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner