Olivia Marie Clark

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.028763 Issued in IL

Practice address

1111 N Milwaukee Ave Unit 323
Vernon Hills, IL 60061-1681

Phone

(714) 309-2019

NPI assigned

Jun 28, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Grayslake, IL
  • NPI 1689141376

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Oasis Therapy Services LLC

  • Multi-Specialty Clinic/Center
  • Oshkosh, WI
  • NPI 1386381598

  IL, Speech-Language Pathologist

  Medicare reassignment NPD
• Story Speech and Voice, LLC

  • Speech-Language Pathologist
  • Vernon Hills, IL
  • NPI 1063373868
  NPD Authorized official
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Speech-Language Pathologist

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1023853108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N MILWAUKEE AVE UNIT 323",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611681",
            "telephone_number": "714-309-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N MILWAUKEE AVE UNIT 323",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611681",
            "telephone_number": "714-309-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "OLIVIA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "0005771",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "35244",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.028763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Chong
• Tat Sun Chow, LMT
• Helena Chuchala
• Carrie Nicole Cicciu-Singer, PT
• Amanda Catherine Clark
• Jeremy Byron Clorfene, PH.D.
• Lisanne Close, O.D.
• Anna Coady
• Christina K. Cobb, B.A CADC
• Stacey Cohen, SLP MA /CCC

• Speech-Language Pathologist in Vernon Hills, IL
• Providers in Vernon Hills, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.