Clark, Keisha Ann

Clark, Keisha Ann is an individual health care provider with primary practice located at 3711 S Vincennes Ave Unit 614, Chicago IL 60653-1882. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, which is considered as her primary health care specialty. Clark, Keisha Ann can be contacted via phone (309) 721-8831.

Contact Information

Primary practice address
3711 S Vincennes Ave Unit 614 Chicago IL 60653-1882
Phone: (309) 721-8831
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X

Profile Details

NPI number 1457690844
LBN Legal business name Clark, Keisha Ann
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2013
Last updated Feb 5th, 2013 - about 12 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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