Gregory O'Neal Clark, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

336.093729 Issued in IL

Practice address

355 W Dundee Rd Ste 110
Buffalo Grove, IL 60089-3500

Phone

(847) 541-4878

Fax

(847) 520-0500

NPI assigned

May 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 22, 2020 through Oct 22, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1053363952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 GRANDVIEW LN",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600453914",
            "telephone_number": "443-823-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W DUNDEE RD STE 110",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600893500",
            "telephone_number": "847-541-4878",
            "fax_number": "847-520-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GREGORY",
        "middle_name": "O'NEAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "336.093729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Y. Chung, M.S.
• Viktor Chykyda, LMT
• Kathryn Cichon
• Claremont Extended Healthcare,LLC (Claremont Rehab & Living Center)
• Claremont Rehab & Living Center
• Taylor Coblentz
• Mark Andrew Cobo, PHARMD
• Dennis Coghlin, LCSW
• Aaron Cohen, MD
• Adam Cohen, DDS

• Endocrinology, Diabetes & Metabolism Physician in Buffalo Grove, IL
• Providers in Buffalo Grove, IL by specialty
• Endocrinology, Diabetes & Metabolism Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.