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General NPI Number Information
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NPI Number | 1164745113
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Entity Type | Individual
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Provider Name | LINDA W CLARKE RN BSN M.ED NCSN
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Gender | Female
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Dates
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Enumeration Date | 03/04/2010
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Last Update Date | 03/04/2010
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Provider Practice Location Address
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Address Line | 7406 S OGLESBY AVE
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City | CHICAGO
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State | IL
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Zip | 60649-3312
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Country | US
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Telephone | 773-768-1117
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Fax | 773-933-6994
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Provider Business Mailing Address
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Address Line | 7406 S OGLESBY AVE
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City | CHICAGO
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State | IL
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Zip | 60649-3312
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Country | US
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Telephone | 773-768-1117
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Fax | 773-933-6994
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 041.195463
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 041.195463
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 041.195463
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 163WC1600X
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Taxonomy Name | Continuing Education/Staff Development Registered Nurse
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License Number | 041.195463
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 041.195463
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 163WN1003X
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Taxonomy Name | Nutrition Support Registered Nurse
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License Number | 041.195463
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License Number State | IL
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Taxonomy #7
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 041.195463
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License Number State | IL
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Taxonomy #8
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Taxonomy Code | 364SC1501X
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Taxonomy Name | Community Health/Public Health Clinical Nurse Specialist
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License Number | 041.195463
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License Number State | IL
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Taxonomy #9
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Taxonomy Code | 364SS0200X
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Taxonomy Name | School Clinical Nurse Specialist
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License Number | 041.195463
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License Number State | IL
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