KRISTEN MARIE CLARK (NPI# 1447717111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447717111 |
| Entity Type | Individual |
| Full Name | KRISTEN MARIE CLARK |
| Credential | NP |
| Practice Address |
1724 W Beach Ave Chicago IL 60622-2108 |
| Practice Telephone | 6303352369 |
| Mailing Telephone | 6303352369 |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2019-02-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209018687 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598264475 | Kristen Clark | Non-emergency Medical Transport (VAN) | 252 American Spirit Rd, Winter Haven, FL 33880-8102 | 2018-02-07 |
| 1174959910 | Kristen Leigh Clark | Licensed Practical Nurse | 105 Edgewood Ave, Buffalo, NY 14220-1765 | 2013-09-25 |
| 1134385933 | Kristen M Clark | Audiologist | 26224 N Tatum Blvd Ste 14, Phoenix, AZ 85050-7500 | 2008-07-31 |
| 1528670502 | Kristen Clark | Speech-Language Pathologist | 2080 Citygate Dr, Columbus, OH 43219-3591 | 2020-08-20 |
| 1609488568 | Kristen Noelle Clark | Behavior Technician | 16941 N Eagle River Loop Rd, Eagle River, AK 99577-7824 | 2020-08-20 |
| 1023575891 | Kristen Clark | Specialist/Technologist | 537 Union Ave, Grants Pass, OR 97527-5543 | 2019-02-27 |
| 1750884508 | Kristen Clark | Occupational Therapist | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2018-03-16 |
| 1245769850 | Kristen Ann Clark | Physician Assistant | 15 Hospital Center Blvd Ste 1, Hilton Head Island, SC 29926-2760 | 2017-06-07 |
| 1336501964 | Kristen Clark | Nurse Practitioner | 3001 N Rocky Point Dr E, Suite 185, Tampa, FL 33607-5810 | 2016-03-23 |
| 1376903385 | Kristen M Clark | Physician Assistant | 200 Robinhood Medical Plz, Winston Salem, NC 27106-5471 | 2016-03-03 |
| Street Address |
1724 W BEACH AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60622-2108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447880471 | Erikson Institute | Clinic/Center | 2739 W Division St, Chicago, IL 60622 | 2020-01-17 |
| 1720620545 | Emily Claire Bonanno | Counselor | 1397 N Miwaukee Ave, Chicago, IL 60622 | 2019-10-14 |
| 1891342093 | Taylor Mallon | Speech-Language Pathologist | 8870 South Duffy Avenue, Apartment 406, Chicago, IL 60622 | 2019-08-22 |
| 1083260277 | Maggie Inman | Student in an Organized Health Care Education/Training Program | 1431 N Claremont Avenue, 2nd Floor Pavilion, Chicago, IL 60622 | 2019-08-13 |
| 1174176168 | Karol Maricel Quelal Analuisa | Internal Medicine | 1901 W Harrison, Chicago Il 60612-3714, Chicago, IL 60622 | 2019-07-19 |
| 1073076105 | Nichole Galullo | Social Worker | 1431 N Claremont 2nd Floor, Chicago, IL 60622 | 2019-04-06 |
| 1003375122 | Alfredo Delgado Perez Sr. | Psychologist | 1127 N Oakley Bvl 3 Floor, Chicago, IL 60622 | 2019-03-18 |
| 1841773439 | Abigail Hector | Counselor | 1521 N Milwaukee Ave, 3n, Chicago, IL 60622 | 2018-09-11 |
| 1164916144 | Dorothy Mitkowski | Student in an Organized Health Care Education/Training Program | 1127 N. Oakley Blvd., 2nd Floor, Chicago, IL 60622 | 2018-06-21 |
| 1255825121 | Kara Lynn Daniel | Speech-Language Pathologist | 1540 N Artesian Ave Apt 2r, Chicago, IL 60622 | 2018-06-14 |
| Find all providers in zip 60622 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1881291706 | Rita Elue | Nurse Practitioner | 6241 N Winthrop Ave Apt 307, Chicago, IL 60660-2071 | 2020-10-04 |
| 1558976514 | Janice Nicole Kinney | Nurse Practitioner | 10127 S Harding Ave, Chicago, IL 60655-3748 | 2020-09-15 |
| 1881209278 | Monique Graves | Nurse Practitioner | 4912 W Adams St Apt 2, Chicago, IL 60644-4445 | 2020-09-11 |
| 1194339721 | Maureen Iyesogie Diji | Nurse Practitioner | 4658 S Ellis Ave, Chicago, IL 60653-3625 | 2020-09-01 |
| 1669085395 | Emily Calderon | Nurse Practitioner | 5556 N Sheridan Rd Apt 506, Chicago, IL 60640-1677 | 2020-08-24 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.