Parks, Clarence A

Parks, Clarence A is an individual health care provider with primary practice located at 1645 W Jackson Blvd Suite 215, Chicago IL 60612-3276. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Parks, Clarence A can be contacted via phone (312) 942-6800.

Contact Information

Primary practice address
1645 W Jackson Blvd Suite 215 Chicago IL 60612-3276
Phone: (312) 942-6800
Fax: (312) 942-3551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036105357 Illinois
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036-105357 Illinois

Profile Details

NPI number 1245203512
LBN Legal business name Parks, Clarence A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Jun 3rd, 2009 - about 15 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 1245203512 NPPES
Illinois MEDICAID 036105351

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