Clark, Nancy S
Clark, Nancy S is an individual health care provider with primary practice located at 75 Remittance Dr Suite 1951, Chicago IL 60675-1001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as her primary health care specialty. Clark, Nancy S can be contacted via phone (847) 535-7917.Contact Information
Primary practice address
75 Remittance Dr Suite 1951
Chicago IL 60675-1001
Phone: (847) 535-7917
Fax: (847) 535-5801
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | 36061363 | Illinois |
Profile Details
| NPI number | 1538145479 |
|---|---|
| LBN Legal business name | Clark, Nancy S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 22nd, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538145479 | NPPES |
| Illinois | MEDICAID | 36061363 |
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