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Contact Information

MEREDITH CLARK
2180 PFINGSTEN RD # 2000
GLENVIEW, IL60026-1339
 Phone: 847-570-1440
 Fax: 847-503-2100
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for MEREDITH CLARK · (Female)

NPI Number 1023609278
Status Active
Credentials
Entity Individual
Enumeration date 01/31/2021
Last updated 05/23/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 085008899
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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