Individual
DR. SCOTT A CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
620 6TH ST, CHARLESTON, IL 61920-2017
(217) 348-0800
(217) 348-0802
Mailing address
620 6TH ST, CHARLESTON, IL 61920-2017
(217) 348-0800
(217) 248-0802
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008347
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008347
—
IL
Enumeration date
12/11/2006
Last updated
07/31/2020
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