Individual
NATHAN EDWARD CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED., BCBA
Contact information
Practice address
4433 W TOUHY AVE STE 335, LINCOLNWOOD, IL 60712-1820
(765) 635-3349
Mailing address
950 LEE ST STE 210, DES PLAINES, IL 60016-6574
(877) 486-4140
(847) 486-4145
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-43731
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-20-43731
BEHAVIOR ANALYST CERTIFICATION BOARD
IL
Enumeration date
07/30/2018
Last updated
08/05/2020
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