TIMETRA DIANE CLARK

CHICAGO, IL
NPI1316687650
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209024791)
Additional Taxonomies163WN0300X Registered Nurse, Nephrology
(Licence: IL  041436444)
163WN0300X Registered Nurse, Nephrology
(Licence: FL  9562544)
363L00000X Nurse Practitioner
(Licence: IL  209024791)
Enumeration Date2022-04-01
Last Update Date2022-04-01
Business Address
TIMETRA DIANE CLARK FNP-BC
1401 E 55TH ST APT 905N
CHICAGO, IL 60615-5468
Phone number: 708-759-3112
Mailing Address
TIMETRA DIANE CLARK FNP-BC
1401 E 55TH ST APT 905N
CHICAGO, IL 60615-5468
Phone number: 708-759-3112