# GREGORY CLARKE M.D., S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881903789
- **Authorized official:** GREGORY CLARKE M.D. (PRESIDENT/OWNER)
- **Authorized official phone:** (312) 236-3175

## Contact information

- **Practice address:** 333 N MICHIGAN AVE, SUITE 2014, CHICAGO, IL 60601-3901
- **Practice address phone:** (312) 236-3175
- **Practice address fax:** (312) 236-3177
- **Mailing address:** PO BOX 802080, CHICAGO, IL 60680-2080
- **Mailing address phone:** (312) 236-3175
- **Mailing address fax:** (312) 236-3177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 036-071641 | IL | Yes |

## Other

- **Enumeration date:** 09/27/2010
- **Last updated:** 09/27/2010