Healthcare Provider Details

I. General information

NPI: 1609341072
Provider Name (Legal Business Name): TARA L KLAUS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1964 SPRINGBROOK SQUARE DR STE 108B
NAPERVILLE IL
60564-5949
US

IV. Provider business mailing address

POB 7132960
CHICAGO IL
60677-0001
US

V. Phone/Fax

Practice location:
  • Phone: 630-348-3840
  • Fax: 630-848-9342
Mailing address:
  • Phone: 630-469-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.018360
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209.018360
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: