Individual
AMIE HOFFMAN CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1197 S BUCHANAN ST, WILMINGTON, IL 60481-1616
(815) 476-5405
(815) 476-7361
Mailing address
190 E 1ST ST, COAL CITY, IL 60416-1628
(815) 955-5471
(815) 476-7361
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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