Aleta V Clark M.D.

NPI 1548269814 - Pediatrics - 2080A0000X

NPI Details
NPI 1548269814
Gender Female
Enumeration Date 07/19/2005
Last Updated 11/25/2009
Entity Type Individual
Active Over 12 years ago
Practice Location
CHICAGO IL, 60610-5467, US
Phone (312) 943-6964
Fax (312) 943-6924
Business Location
PO BOX 189
MATTESON IL, 60443-0189, US
Phone (708) 747-5850
Fax (708) 747-9991
Taxonomy Code 2080A0000X
License State Illinois
License Number 036051208
Remove 1548269814 NPI Number

According to our database, Aleta V Clark M.D. NPI is 1548269814, taxonomy code is 2080A0000X and license number is 036051208, license state is located at Illinois. Aleta V Clark M.D. physically located at 1030 N Clark St, Chicago IL, 60610-5467. NPI Number Aleta V Clark M.D. has the Individual type.

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1548269814 NPI number is provided on an as is basis without warranty of any kind. 1548269814 is maintained by the National Plan & Provider Enumeration System. The contents of Aleta V Clark M.D. are for informational purposes only.