Healthcare Provider Details

I. General information

NPI: 1932647773
Provider Name (Legal Business Name): CARA A LOCKLIN APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2017
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 W TOUHY AVE
CHICAGO IL
60645-3412
US

IV. Provider business mailing address

1672 W HOLLYWOOD AVE APT 1W
CHICAGO IL
60660-4013
US

V. Phone/Fax

Practice location:
  • Phone: 773-751-1875
  • Fax:
Mailing address:
  • Phone: 734-395-8344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209015506
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.015506
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.414087
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: