Cordia Marie Clark-White, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036-119447 Issued in IL

Practice address

1645 W Jackson Blvd Ste 310
Chicago, IL 60612-3227

Phone

(312) 942-8060

Fax

(312) 942-8222

NPI assigned

Dec 18, 2007

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 2

Other names 1

• Cordia Marie White Former name

Medicare fee-for-service enrollment

Enrolled in IL

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.

Enrollment records 1

Specialty

Obstetrics/GynecologyAlso: General Surgery

Education

R Franklin University of Med & Sci/Chicago Medical School, 2003

Medicare assignment

May accept Medicare assignment

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
• Rush University Medical Center Hospital, Chicago, IL, CCN 140119

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cclarkwhite131952@direct.rush.rush-health.com

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.

• Cordia M. Clark-White, MD, LTD

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1255889622
  Medicare reassignment NPD Authorized official
• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Rush University Medical Center

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1689165540

  Obstetrics & Gynecology

  NPD
• Serenity Breast Health and Wellness PLLC

  • Surgery Physician
  • Chicago, IL
  • NPI 1205671237
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Dupage Hospital Association

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation
• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728
  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Care Compare affiliation

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1861676538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3473 S KING DR # 472",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164108",
            "telephone_number": "708-207-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123227",
            "telephone_number": "312-942-8060",
            "fax_number": "312-942-8222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 S Michigan Ave Ste 305",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606162857",
            "country_code": "US",
            "telephone_number": "312-326-1792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK-WHITE",
        "first_name": "CORDIA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-119447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1619478",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036119447",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORDIA",
            "last_name": "WHITE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Clark Manor Convalescent Center, Inc
• Clark Pharmacy Inc
• Clark Skilled Nursing Facility LLC
• Allison Clark Young, APN
• Cynthia June Clark-Bumgarner, CRNA
• Donna Ree Clark-White
• Julianna Clark-Wronski
• Aaron J Clark, MD
• Abner Clark
• Aimee P Clark, MS, APRN, CNM

• Obstetrics & Gynecology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.
• 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.