Individual
WILLIAM M CLARK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
737 N MICHIGAN AVE, SUITE 1200, CHICAGO, IL 60611
(312) 373-7300
(312) 573-1249
Mailing address
737 N MICHIGAN AVE, SUITE 1200, CHICAGO, IL 60611
(312) 373-7300
(312) 573-1249
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
336 040184
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01615704
BLUE CROSS
IL
05
—
0360770
—
IL
01
—
260041526
RAILROAD
IL
Enumeration date
08/10/2006
Last updated
07/13/2010
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