Mallory Marie Klocke, CNM

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209017990 Issued in IL

Practice address

17 N State St Ste 500
Chicago, IL 60602-3384

Phone

(712) 210-2717

NPI assigned

Aug 30, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Planned Parenthood of Illinois

  • Clinic/Center
  • Chicago, IL
  • NPI 1790754745
  NPD (past)
• Femhealth USA, Inc

  • Ambulatory Family Planning Facility
  • Chevy Chase, MD
  • NPI 1578960548
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1043792641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7060 N GREENVIEW AVE APT 2N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606262831",
            "telephone_number": "712-210-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 N STATE ST STE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023384",
            "telephone_number": "712-210-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOCKE",
        "first_name": "MALLORY",
        "middle_name": "MARIE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209017990",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209017990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Klis
• Megan Klitzke, DO
• Elizabeth Kliver, PT, DPT
• Susan Klock, PHD
• Francis John Klocke, MD
• Lauren Kloeppinger, PA-C
• Jacob Kloet
• Kate Kloet, MS, RDN, LDN
• Michael Alan Klonowski, DPT
• Jonathan Klopcic, DC

• Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.