Provider Demographics
NPI:1184993552
Name:CLARK, AIMEE P (MS, APRN, CNM)
Entity type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:P
Last Name:CLARK
Suffix:
Gender:F
Credentials:MS, APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 N LAKE SHORE DR STE 815
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4449
Mailing Address - Country:US
Mailing Address - Phone:312-926-8811
Mailing Address - Fax:312-926-8855
Practice Address - Street 1:680 N LAKE SHORE DR STE 815
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4449
Practice Address - Country:US
Practice Address - Phone:312-926-8811
Practice Address - Fax:312-926-8855
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife