Clark, Elijah Boone

Clark, Elijah Boone is an individual health care provider with primary practice located at 408 S Neil St , Champaign IL 61820-5218. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Clark, Elijah Boone can be contacted via phone (217) 337-2995.

Contact Information

Primary practice address
408 S Neil St Champaign IL 61820-5218
Phone: (217) 337-2995
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1962128595
LBN Legal business name Clark, Elijah Boone
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2022
Last updated Oct 14th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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