Clark, Timetra Diane

Clark, Timetra Diane is an sole proprietor health care provider with primary practice located at 1401 E 55Th St Apt 905N , Chicago IL 60615-5468. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Nephrology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Clark, Timetra Diane can be contacted via phone (708) 759-3112.

Contact Information

Primary practice address
1401 E 55Th St Apt 905N Chicago IL 60615-5468
Phone: (708) 759-3112
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Nephrology 163WN0300X 041436444 Illinois
Nursing Service Providers / Nephrology 163WN0300X 9562544 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209024791 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209024791 Illinois

Profile Details

NPI number 1316687650
LBN Legal business name Clark, Timetra Diane
Credentials FNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 1st, 2022
Last updated Apr 1st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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