Individual
MEREDITH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2180 PFINGSTEN RD # 2000, GLENVIEW, IL 60026-1339
(847) 570-1440
(847) 503-2100
Mailing address
2180 PFINGSTEN RD # 2000, GLENVIEW, IL 60026-1339
(847) 570-1440
(847) 503-2100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085008899
IL
363AS0400X
Surgical Physician Assistant
Primary
085008899
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/31/2021
Last updated
05/23/2022
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