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Individual

DR. DEBORAH S CLEMENTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1275 E BELVIDERE RD, SUITE 250, GRAYSLAKE, IL 60030-2082
(847) 926-0106
Mailing address
710 N LAKE SHORE DR, ABBOTT HALL, 4TH FLOOR, CHICAGO, IL 60611-3006
(312) 503-1275

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-28569
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200003340B
KS
05
209401900
MO
01
26402044
BCBS KANSAS CITY
MO
01
373060
FIRSTGUARD
KS
Enumeration date
10/04/2006
Last updated
05/22/2013
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