Individual
OLIVIA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11560 S KEDZIE AVE, MERRIONETTE PARK, IL 60803-4517
(708) 974-5800
Mailing address
716 E 163RD ST, SOUTH HOLLAND, IL 60473-2309
(941) 345-0855
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.112228
IL
Other
Enumeration date
07/17/2026
Last updated
07/17/2026
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