Individual provider · Type 1 NPI
Mallory Marie Klocke, CNM
Nurse Practitioner · Chicago, IL
Practice location
17 N State St Ste 500
Chicago, IL 60602-3384
Mailing address
7060 N Greenview Ave Apt 2N
Chicago, IL 60626-2831
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Advanced Practice Midwife | 367A00000X | 209017990 (IL) |
| Nurse Practitioner Primary | 363L00000X | 209017990 (IL) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1043792641
Mallory Marie Klocke, CNM's National Provider Identifier is 1043792641, issued on Aug 30, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Chicago, IL. The record was last updated on Feb 4, 2025.