Nancy S Clark, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

36061363 Issued in IL

Practice address

75 Remittance Dr
Suite 1951
Chicago, IL 60675-1001

Phone

(847) 535-7917

Fax

(847) 535-5801

NPI assigned

Dec 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538145479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 N WESTMORELAND RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451659",
            "telephone_number": "847-535-7917",
            "fax_number": "847-535-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 REMITTANCE DR",
            "address_2": "SUITE 1951",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751001",
            "telephone_number": "847-535-7917",
            "fax_number": "847-535-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NANCY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "36061363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36061363",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcus Clark
• Margaret Harrigan Clark, M.A.
• Marlena Clark, PHD
• Melissa A Clark, LCSW
• Mike A Clark, OT
• Clark, Nelson, and Associates, Inc.
• Richard N Clark Jr., MD
• Rona Clark
• Sara Elizabeth Clark, MS, OTR/L
• Sarah Clark, LCSW

• Emergency Medical Services (Emergency Medicine) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.