| Stephen J. Clark M.d.,p.c. | |
|
3021 Falling Waters Blvd Suite A Lindenhurst IL 60046-6793 | |
| (847) 356-9300 | |
| (847) 356-7260 |
| Full Name | Stephen J. Clark M.d.,p.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3021 Falling Waters Blvd, Lindenhurst, Illinois |
| Authorized Official Name and Position | Stephen J. Clark (PRESIDENT) |
| Authorized Official Contact | 8473569300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen J. Clark M.d.,p.c. 3021 Falling Waters Blvd Suite A Lindenhurst IL 60046-6793 Ph: (847) 356-9300 | Stephen J. Clark M.d.,p.c. 3021 Falling Waters Blvd Suite A Lindenhurst IL 60046-6793 Ph: (847) 356-9300 |
| NPI Number | 1487772208 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2466408554 |
|---|---|
| Medicare Enrollment ID | O20050322000781 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487772208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Illinois) | Primary |
| Provider Name | Stephen J Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538123385 PECOS PAC ID: 4789630880 Enrollment ID: I20050919000437 |
| Provider Name | Thomas M Mcgowan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033173893 PECOS PAC ID: 5193758282 Enrollment ID: I20050919000476 |
The Vista Surgery And Treatment Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1050 Red Oak Ln, Lindenhurst, IL 60046 Phone: 847-356-4700 |