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MALLORY MARIE KLOCKE CNM
NPI 1043792641
Nurse Practitioner in Chicago, IL

Active since August 30, 2018
17 N STATE ST STE 500, CHICAGO, IL 60602(712) 210-2717 Get Directions Write a Review

NPPES record last updated: February 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 4, 2025, Apr 2, 2019, Aug 30, 2018 (3 updates tracked since 2018).

About Mallory Marie Klocke Cnm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALLORY MARIE KLOCKE CNM (NPI 1043792641) is an individual nurse practitioner in Chicago, Illinois, licensed in Illinois (209017990) and active in the NPI registry since August 2018.

NPPES Registry Identity

NPI1043792641
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMALLORY MARIE KLOCKECredential: CNM
Location Address17 N STATE ST STE 500Chicago, IL 60602-3384
Mailing Address7060 N Greenview Ave Apt 2nChicago, IL 60626-2831 · (712) 210-2717
Phone(712) 210-2717
Sole ProprietorNo
Enumeration DateAugust 30, 2018
Last NPPES UpdateFebruary 4, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 4, 2025
✔ NPI 1043792641 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in IL · 209017990
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedAdvanced Practice MidwifeTaxonomy 367A00000X · License 209017990 (IL)
17 N STATE ST STE 500, Chicago, IL 60602
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mallory Klocke's NPI number?

The NPI number for Mallory Klocke is 1043792641. It was assigned to this individual provider in the NPPES registry on August 30, 2018.

Where is Mallory Klocke located?

Mallory Klocke practices at 17 N State St Ste 500, Chicago, IL 60602. The listed phone number is (712) 210-2717.

What is Mallory Klocke's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Mallory Klocke was last updated on February 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.