Organization
PATRICIA CLARK MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA L CLARK M.D. (PRESIDENT)
(708) 460-9833
Entity
Organization
Contact information
Practice address
12701 W 143RD ST, HOMER GLEN, IL 60491-7715
(815) 846-3358
(708) 460-1117
Mailing address
PO BOX 379, ORLAND PARK, IL 60462-0379
(708) 460-9833
(708) 460-1117
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
03611578
IL
Other
Enumeration date
08/23/2012
Last updated
08/23/2012
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