Clark, Elizabeth Talley

Clark, Elizabeth Talley is an sole proprietor health care provider with primary practice located at 1614 W Central Rd Suite 100, Arlington Heights IL 60005-2490. She recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as her primary health care specialty. Clark, Elizabeth Talley can be contacted via phone (847) 577-5814.

Contact Information

Primary practice address
1614 W Central Rd Suite 100 Arlington Heights IL 60005-2490
Phone: (847) 577-5814
Fax: (847) 577-5914
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 036-076927 Illinois

Profile Details

NPI number 1487646535
LBN Legal business name Clark, Elizabeth Talley
Credentials M.D., R.V.T.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 16th, 2005
Last updated Apr 24th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487646535 NPPES
Illinois Other 1487646535 NPI
Illinois MEDICAID 036-076927-1 NPI

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