| Doctor Name: | KRISTEN KLOCKER |
| NPI Number: | 1073844981 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 209.007849 |
| Business Practice Address: | 473 W Army Trail Rd 103 Bloomingdale, IL - 601082674 |
| Business Phone Number: | 6305296969 |
| Business Fax Number: | |
| Mailing Address: | 473 W Army Trail Rd, Suite 103 BLOOMINGDALE |
| State: | IL |
| Postal Code: | 601082674 |
| Phone Number: | 6305296969 |
| Fax Number: | 6305295993 |
| NPI Enumeration Date: | 01/18/2010 |
| NPI Last Update Date: | 01/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 209.007849 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |