Clark, Joseph I

Clark, Joseph I is an individual health care provider with primary practice located at 2160 S First Ave Luh-North Ent., Rm. 7604, Maywood IL 60153. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Clark, Joseph I can be contacted via phone (708) 216-3304.

Contact Information

Primary practice address
2160 S First Ave Luh-North Ent., Rm. 7604 Maywood IL 60153
Phone: (708) 216-3304
Fax: (708) 216-1259
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 36083048 Illinois

Profile Details

NPI number 1972580843
LBN Legal business name Clark, Joseph I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2005
Last updated Jan 28th, 2022 - about 2 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1972580843 NPPES
Illinois MEDICAID 36083048

Popular Providers