Individual
HANNAH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
503 MCMILLAN RD, WEST MONROE, LA 71291-5327
(318) 323-8887
(847) 615-2858
Mailing address
925 SHERWOOD DR, LAKE BLUFF, IL 60044-2203
(318) 323-8887
(847) 615-2858
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
012790
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1188140
—
LA
Enumeration date
07/12/2006
Last updated
07/08/2007
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