Organization
CLARK AND SCHULZE NP PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL CLARK (NP/OPERATING AGENT)
(618) 367-3732
Entity
Organization
Contact information
Practice address
1806 WOODFIELD DR OFC 111, SAVOY, IL 61874-9505
(618) 367-3732
Mailing address
1806 WOODFIELD DR, SAVOY, IL 61874-9505
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427557321
NPI
—
01
—
1972979409
NPI
—
Enumeration date
10/03/2022
Last updated
10/03/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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