Kendra Clark
Individual provider Active NPI Case Manager/Care Coordinator · East Dundee, IL
NPI 1831661958 · NPPES record last updated Dec 31, 2018
Key facts
- NPI
- 1831661958
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 455 E Main St
East Dundee, IL 60118-1529 - Phone
- (847) 428-2273
- NPI assigned
- Dec 31, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
455 E Main St
East Dundee, IL 60118-1529
Mailing address
7 Hills Healthcare Center
455 E Main St.
East Dundee, IL 60118
Phone (847) 428-2273
Other practice location 1
7 Hills Healthcare Center
455 E Main St
east dundee, IL 60118
Phone (847) 428-2273
Other practice location 2
455 E Main St
East Dundee, IL 60118-1529
Phone (847) 428-2273
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 171M00000X | Medicaid | IL |
Other providers in East Dundee, IL
- Aaron Bush
- Kayla Camp
- Belgica Johana Cardoso
- Center for Chiropractic and Natural Medicine SC
- Panita Chiemmongkoltip
- Kirsten Sandra Cook
- Amish V Desai
- Lindsay Dort
- Russell Dumas
- Dundee Smile Center, LTD.
All providers in East Dundee, IL · Case Manager/Care Coordinator in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.