Individual
KILMENY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3024 E EMPIRE ST, BLOOMINGTON, IL 61704-5402
(309) 556-7556
(309) 556-7551
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.008097
IL
363A00000X
Physician Assistant
5318-23
WI
Other
Enumeration date
07/05/2020
Last updated
06/09/2025
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