Clark, Richard D
Clark, Richard D is an sole proprietor health care provider with primary practice located at 18221 Torrence Ave , Lansing IL 60438-2870. He recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Clark, Richard D can be contacted via phone (708) 895-9450.Contact Information
Primary practice address
18221 Torrence Ave
Lansing IL 60438-2870
Phone: (708) 895-9450
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | 1484659051 | Kansas |
| Nursing Service Providers / Registered Nurse | 163W00000X | 134677 | Missouri |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 54725 | Kansas |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 54725 | Kansas |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 134677 | Missouri |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 09.006191 | Illinois |
Profile Details
| NPI number | 1659355121 |
|---|---|
| LBN Legal business name | Clark, Richard D |
| Credentials | RN ARNP CRNA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 30th, 2005 |
| Last updated | May 21st, 2010 - about 16 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 | 1659355121 | NPPES |
| Other | 161280 | BCBS OF KANSAS | |
| Other | 481192875 | BCBS OF KANSAS | |
| Other | P00155221 | BCBS OF KANSAS | |
| Other | P13178 | BCBS OF KANSAS | |
| Other | 27862039 | BCBS OF KANSAS | |
| Other | 27862039 | BCBS OF KANSAS | |
| Other | 27862039 | BCBS OF KANSAS | |
| Other | 481192875 | BCBS OF KANSAS | |
| Other | 481192875 | BCBS OF KANSAS | |
| MEDICAID | 915697213 | BCBS OF KANSAS | |
| Other | 481192875 | BCBS OF KANSAS | |
| Other | 481192875 | BCBS OF KANSAS | |
| Other | 100385650C | BCBS OF KANSAS | |
| Other | 10001771600 | BCBS OF KANSAS |
Popular Providers
-
Flynn, Julie A.
18221 Torrence Ave , Lansing IL 60438-2870 -
Tomczak, Mark A
18221 Torrence Ave Suite 1B, Lansing IL 60438-2870 -
Garry, Kelly Jean
18221 Torrence Ave , Lansing IL 60438-2870 -
Robb, Marianne
1 E New York Ave , Somers Point NJ 08244-2340 -
Nardelli, Catherine
1 E New York Ave , Somers Point NJ 08244-2340 -
Munnich, Amanda Brittney
3033 191St Pl , Lansing IL 60438-3713 -
Cole, Adam Edward
18221 Torrence Ave , Lansing IL 60438-2870 -
Shariff, Maria-Paz Salazar
18221 Torrence Ave Ste 1B , Lansing IL 60438-2870