Individual
NICOLE ANNE CLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(888) 824-0200
Mailing address
150 HARVESTER DR STE 300, BURR RIDGE, IL 60527-5965
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1-133121
AL
363L00000X
Nurse Practitioner
Primary
209020656
IL
363L00000X
Nurse Practitioner
Primary
ARNP9409592
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016992700
—
FL
01
—
13548879
CAQH
FL
01
—
Q3K4T
BCBSFL
FL
Enumeration date
04/25/2015
Last updated
03/03/2026
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