Individual
CHRISTINE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
820 S DAMEN AVE, JESSE BROWN VA MEDICAL CENTER, CHICAGO, IL 60612-3728
(312) 569-7562
Mailing address
40W709 WHITE FENCE WAY, ST CHARLES, IL 60175-8528
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
—
IL
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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