Individual
STEPHANIE ALLISON KLUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CPNP-AC
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(708) 606-3253
Mailing address
4002 PINE ST, MICHIGAN CITY, IN 46360-6624
(708) 606-3253
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
209.021490
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202010582
PEDIATRIC NURSING CERTIFICATION BOARD
—
01
—
209.021490
STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
07/11/2020
Last updated
12/28/2021
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