Doctor Name: | KRIS MC CLURE |
NPI Number: | 1053384099 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 209-000603 |
Business Practice Address: | 518 Lucinda Ave University Health Services, Niu Dekalb, IL - 601152828 |
Business Phone Number: | 8157531311 |
Business Fax Number: | 8157539599 |
Mailing Address: | 518 Lucinda Av, University Health Services, Northern Illinois Univers DEKALB |
State: | IL |
Postal Code: | 60115 |
Phone Number: | 8157531311 |
Fax Number: | 8157539599 |
NPI Enumeration Date: | 02/09/2006 |
NPI Last Update Date: | 05/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0001X |
License Number: | 209-000603 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Obstetrics & Gynecology |
Taxonomy Definition: |