Clark, Kelly Dawn

Clark, Kelly Dawn is an individual health care provider with primary practice located at 1802 S Mattis Ave , Champaign IL 61821-5923. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Clark, Kelly Dawn can be contacted via phone (217) 326-1399.

Contact Information

Primary practice address
1802 S Mattis Ave Champaign IL 61821-5923
Phone: (217) 326-1399
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X Illinois

Profile Details

NPI number 1780703520
LBN Legal business name Clark, Kelly Dawn
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2007
Last updated Jul 8th, 2007 - about 19 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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