Timetra Diane Clark
FNP-BC | Nurse Practitioner | 4+ years Exp
1401 E 55th St Apt 905n, Chicago
Illinois, 60615-5468
708-759-3112
Timetra Diane Clark is a Chicago, Illinois based nurse practitioner with 4 years of experience in Nurse Practitioner. She completed her graduation in 2021. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Timetra Diane Clark is 209024791 for Family in Illinois. Her current practice location is 1401 E 55th St Apt 905n, Chicago. Patients can reach her at 708-759-3112. Timetra Diane Clark is FNP-BC with specialization in Nurse Practitioner and her NPI number (Unique professional ID assigned by NPPES) is 1316687650.
Timetra Diane Clark has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Timetra Diane Clark speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Timetra Diane Clark |
| Specialization: | Nurse Practitioner Nurse Practitioner (NP) |
| Gender: | Female |
| Credentials: | FNP-BC |
| Experience: | 4+ years |
| Medical School Attended: | Other |
| Graduation Year: | 2021 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 1401 E 55th St Apt 905n, Chicago,
Illinois, 60615-5468 |
| Phone: | 708-759-3112 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 5294117230 |
| Enrollment ID: | I20220808000599 |
| NPI Number: | 1316687650 |
| NPI Enumeration Date: | 01 Apr, 2022 |
| NPI Last Update On: | 01 Apr, 2022 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Timetra Diane Clark are as mentioned below.
| License Number | Specialization | State | Status | |
| 209024791 | Family | Illinois | Primary | |
| 041436444 | Registered Nurse | Illinois | Secondary | |
| 9562544 | Registered Nurse | Florida | Secondary | |
| 209024791 | Nurse Practitioner | Illinois | Secondary | |
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Timetra Diane Clark is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Midwest Express Care 2 Inc (0547495467) | 109 |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Timetra Diane Clark
1401 E 55th St Apt 905n,
Chicago, Illinois |
| Zip: | 60615-5468 |
| Phone Number: | 708-759-3112 |
Patients can reach Timetra Diane Clark at
1401 E 55th St Apt 905n, Chicago, Illinois or can
call to book an appointment on 708-759-3112.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.