Clark, Elizabeth Talley
Clark, Elizabeth Talley is an sole proprietor health care provider with primary practice located at 1614 W Central Rd Suite 100, Arlington Heights IL 60005-2490. She recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as her primary health care specialty. Clark, Elizabeth Talley can be contacted via phone (847) 577-5814.Contact Information
Primary practice address
1614 W Central Rd Suite 100
Arlington Heights IL 60005-2490
Phone: (847) 577-5814
Fax: (847) 577-5914
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 036-076927 | Illinois |
Profile Details
| NPI number | 1487646535 |
|---|---|
| LBN Legal business name | Clark, Elizabeth Talley |
| Credentials | M.D., R.V.T. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2005 |
| Last updated | Apr 24th, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487646535 | NPPES |
| Illinois | Other | 1487646535 | NPI |
| Illinois | MEDICAID | 036-076927-1 | NPI |
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