Clark, Steven G

Clark, Steven G is an individual health care provider with primary practice located at 2351 Broadway St , Pekin IL 61554-3972. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Clark, Steven G can be contacted via phone (309) 353-4159.

Contact Information

Primary practice address
2351 Broadway St Pekin IL 61554-3972
Phone: (309) 353-4159
Fax: (309) 353-4531
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 036049330 Illinois

Profile Details

NPI number 1902850027
LBN Legal business name Clark, Steven G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Nov 26th, 2014 - about 11 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 1902850027 NPPES
Illinois MEDICAID 036049330
Illinois Other 09015685
Illinois Other P00355237

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