Provider Demographics
NPI:1538632880
Name:KLEIGER, COLLEEN (MSW, LSW)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:KLEIGER
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:222 E WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5426
Mailing Address - Country:US
Mailing Address - Phone:630-784-4866
Mailing Address - Fax:
Practice Address - Street 1:222 E WILLOW AVE
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5426
Practice Address - Country:US
Practice Address - Phone:630-699-6551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150101511104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker