Individual
SEAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
2003 W FULTON ST STE 300, CHICAGO, IL 60612-2345
(312) 850-3438
Mailing address
3230 WESLEY AVE, BERWYN, IL 60402-3462
(618) 204-7575
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
IL
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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