Nathanial Clark, D.C., S.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038011046 Issued in IL

Legal business name

NATHANIAL CLARK, D.C., S.C.

Practice address

1475 N Dilleys Rd
Unit 2
Gurnee, IL 60031-1708

Phone

(847) 244-8600

Fax

(847) 244-8602

NPI assigned

Dec 14, 2007

Last updated

Mar 28, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nathanial B Clark, D.C.NPI 1437339678

Title

Owner/President

Phone

(847) 244-8600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nathanial Bradley Clark, D.C.

  • Chiropractor
  • Gurnee, IL
  • NPI 1437339678
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301270400000",
    "number": "1477736221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 N DILLEYS RD",
            "address_2": "UNIT 2",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600311708",
            "telephone_number": "847-244-8600",
            "fax_number": "847-244-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 N DILLEYS RD",
            "address_2": "UNIT 2",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600311708",
            "telephone_number": "847-244-8600",
            "fax_number": "847-244-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHANIAL CLARK, D.C., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2011-03-28",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "NATHANIAL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "847-244-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul J Myles, PHARM.D.
• Peter N.G., PHARMD
• Nirav Nagarsheth
• Maryellen Nardomarino, PT
• Audey Nasser, DPM
• National Medical Care Inc (Neomedica Gurnee)
• National Vision, Inc. (America's Best Contacts & Eyeglasses)
• Nature First Medical Clinic, SC
• Matthew Nauman, PT
• Kailey Nava, PT, DPT

• Chiropractor in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.