Engstrom, Clarence D

Engstrom, Clarence D is an individual health care provider with primary practice located at 3115 Lewis Ave , Zion IL 60099-3099. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Engstrom, Clarence D can be contacted via phone (847) 746-3752.

Contact Information

Primary practice address
3115 Lewis Ave Zion IL 60099-3099
Phone: (847) 746-3752
Fax: (847) 746-9144
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036040526 Illinois

Profile Details

NPI number 1356327514
LBN Legal business name Engstrom, Clarence D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2005
Last updated Dec 6th, 2021 - about 4 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 1356327514 NPPES
Illinois MEDICAID 036040526

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