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Individual

DR. SUSAN H CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1004 ASH ST, WINNETKA, IL 60093-2102
(312) 952-3392
(847) 501-3857
Mailing address
1004 ASH ST, WINNETKA, IL 60093-2102
(312) 952-3392
(847) 501-3857

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036060118
IL
2084P0800X
Psychiatry Physician
03606118
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
537220
PIN
Enumeration date
11/07/2006
Last updated
06/05/2022
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