Organization
GREGORY CLARKE M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY CLARKE M.D. (PRESIDENT/OWNER)
(312) 236-3175
Entity
Organization
Contact information
Practice address
333 N MICHIGAN AVE, SUITE 2014, CHICAGO, IL 60601-3901
(312) 236-3175
(312) 236-3177
Mailing address
PO BOX 802080, CHICAGO, IL 60680-2080
(312) 236-3175
(312) 236-3177
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
036-071641
IL
Other
Enumeration date
09/27/2010
Last updated
09/27/2010
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