Individual
KIMBERLY NICOLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS, PA-C
Contact information
Practice address
1600 N RANDALL RD STE 400, ELGIN, IL 60123-7805
(847) 381-8899
Mailing address
0N331 ETHEL ST, WINFIELD, IL 60190-1051
(630) 890-2775
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.007399
IL
Other
Enumeration date
11/20/2019
Last updated
12/16/2021
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