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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

TIMETRA DIANE CLARK, FNP-BC

Active Sole Proprietor

Family Nurse Practitioner · CHICAGO, IL

Registration Details

NPI Number
1316687650
Provider Type
Individual
Gender
Female
NPI Issued
Apr 1, 2022 (4.0752131333574 yrs)
Last Updated
Apr 1, 2022
Licenses
041436444 (IL)
9562544 (FL)
209024791 (IL)
209024791 (IL)
Sole Proprietor
Yes

Practice Information

Address
1401 E 55TH ST APT 905N
CHICAGO, IL, 606155468
Browse IL providers · Browse ZIP 60615
Phone
7087593112
Primary Specialty
Family Nurse Practitioner
363LF0000X
Additional Specialty
Nephrology Nurse
Additional Specialty
Nurse Practitioner
Additional Specialty
Family Nurse Practitioner

Other Family Nurse Practitioner Providers in CHICAGO, IL

Name Credential NPI
ANNE E TURNER ANP-C 1487658084
YANA DYMARSKIY APRN, FNP 1154322097
MARY L TORNABENE APN 1730180621
SARAH LAU APN 1548254378
CYNTHIA D DAVIS FNP 1902897028
VALERIE URYGA NP 1154309151
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.