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Individual
MR. MICHAEL J CLARKE
Active
Individual
MR. MICHAEL J CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA-CCC. SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
34-154
WI
235Z00000X
Speech-Language Pathologist
MC19430399P
IL
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04927751
BLUE CROSS BLUE SHIELD
IL
01
—
481943 CLA
UNITED HEALTHCARE
IL
Enumeration date
01/02/2007
Last updated
04/20/2008
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