Provider Demographics
NPI:1821171091
Name:KLIMA, CARRIE (CNM, APN)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:
Last Name:KLIMA
Suffix:
Gender:F
Credentials:CNM, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 S MARSHFIELD AVE
Mailing Address - Street 2:9TH FLOOR (M/C 732)
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4305
Mailing Address - Country:US
Mailing Address - Phone:312-996-7699
Mailing Address - Fax:312-996-1001
Practice Address - Street 1:845 S. DAMEN (MC 802
Practice Address - Street 2:UIC COLLEGE OF NURSING
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-996-1863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-002877207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology