Individual
MALLORY MARIE KLOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
17 N STATE ST STE 500, CHICAGO, IL 60602-3384
(712) 210-2717
Mailing address
7060 N GREENVIEW AVE APT 2N, CHICAGO, IL 60626-2831
(712) 210-2717
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209017990
IL
367A00000X
Advanced Practice Midwife
209017990
IL
Other
Enumeration date
08/30/2018
Last updated
02/04/2025
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