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Individual

MARK C CLARKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2300 N EDWARD ST, DECATUR, IL 62526
(217) 876-5023
(217) 876-5013
Mailing address
6450 RELIABLE PARKWAY, CHICAGO, IL 60686
(217) 788-3000
(217) 788-5577

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0360864171
IL
Enumeration date
08/16/2006
Last updated
07/08/2007
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