Individual provider · Type 1 NPI
Tracie E. Clisby
Family Nurse Practitioner · Chicago, IL
NPI number
1942574769
Active
Practice location
5841 S Maryland Ave
Chicago, IL 60637-1443
Mailing address
PO Box 5367
Chicago, IL 60680-5367
Other practice locations
- 433 W Harrison St Ste 5367, Chicago, IL 60699-3916 · (773) 340-1307
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 277002085 (IL) |
| Family Nurse Practitioner Primary | 363LF0000X | 277.002085 (IL) |
Family Nurse Practitioner: Definition to come...
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About NPI 1942574769
Tracie E. Clisby's National Provider Identifier is 1942574769, issued on Feb 24, 2012. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Chicago, IL. The record was last updated on Mar 11, 2024.