DANIEL L CLARK DO LTD (NPI# 1093893117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093893117 |
| Entity Type | Organization |
| Organization Name | DANIEL L CLARK DO LTD |
| Practice Address |
14831 W 159th St Harris Bank Building Lockport IL 60491 |
| Practice Telephone | 8158380052 |
| Practice Fax Number | 8158384410 |
| Mailing Telephone | 8158380052 |
| Mailing Fax Number | 8158384410 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DANIEL LEE CLARK (PRESIDENT) |
| Authorized Official Telephone | 8158380052 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036071157 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 0991512865 | 01 |
| Street Address |
14831 W 159TH ST HARRIS BANK BUILDING |
| City | LOCKPORT |
| State | IL |
| Zip Code | 60491 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225487481 | Khalil Snowber | Family Medicine | 14831 W 159th St, Lockport, IL 60491-9005 | 2016-06-08 |
| 1497833511 | Daniel Lee Clark | Family Medicine | 14831 W 159th St, Harris Bank Building, Lockport, IL 60491 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417490681 | Kellie Calderon | Counselor | 14007 S Bell Rd Ste 183, Homer Glen, IL 60491 | 2016-11-21 |
| 1811249915 | Jasmina Peric | Registered Nurse | 14607 Stonegate Drive, Homer Glen, IL 60491 | 2012-10-12 |
| 1700137783 | Nicole Marie Karn | Physical Therapy Assistant | 14319 Twin Creek Lane, Homer Geln, IL 60491 | 2012-10-01 |
| 1992062061 | South Suburban Hearing, Inc | Hearing Instrument Specialist | 14316 S. Will-cook Rd, Homer Glen, IL 60491 | 2012-04-13 |
| 1336417385 | Crystal Knaack | Pharmacist | 13911 W 167th St, Homer Glen, IL 60491 | 2011-12-06 |
| 1891976429 | Toothworks Inc | Dentist | 12626 W 159th St, Homer Glen, IL 60491 | 2007-11-26 |
| 1972639441 | Barbara A Bayer | Social Worker | 13528 Marissa Ct, Homer Glen, IL 60491 | 2007-02-26 |
| 1720006752 | Judith Polkow | Physical Therapist | 14821 S. Founders Crossing, Homer Glen, IL 60491 | 2006-07-17 |
| 1518902188 | Allen Ophthalmic Group | Ophthalmology | 15933 South Bell Road, Homer Glen, IL 60491 | 2006-06-18 |
| 1083606628 | Lynn M Koehler | Internal Medicine | 15929 S Bell Rd, Homer Glen, IL 60491 | 2005-08-19 |
| Find all providers in zip 60491 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720348261 | Bianca Angelica Belli | Family Medicine | 5875 S. Transit Road, Lockport, NY 14094 | 2012-05-17 |
| 1528104007 | Charles Olick | Family Medicine | 5258 Mapleton Rd, Lockport, NY 14094-9293 | 2007-01-30 |
| 1609959543 | Eastview Family Practice PC | Family Medicine | 294 East Avenue, Lockport, NY 14094 | 2006-10-23 |
| 1982628574 | Nicholas Varallo | Family Medicine | 670 Davison Road, Lockport, NY 14094-5338 | 2006-07-27 |
| 1639196421 | Frederick J Piwko | Family Medicine | 3805 Lockport Olcott Rd, Lockport, NY 14094-1128 | 2006-07-16 |
| 1861439879 | Patricia J Danaher | Family Medicine | 5949 Campbell Blvd, Lockport, NY 14094-9204 | 2006-05-31 |
| 1669427589 | Rajeswara Nagalla | Family Medicine | 131 East Ave, Lockport, NY 14094-3838 | 2006-05-23 |
| 1194776377 | Mirza Khalid M Baig | Family Medicine | 1206 E 9th St Ste 320, Lockport, IL 60441-2404 | 2006-05-13 |
| 1457315707 | Fiona C Halliday | Family Medicine | 5879 Snyder Dr, Lockport, NY 14094-9497 | 2006-04-13 |
| 1154381317 | Thomas Hughes | Family Medicine | 64 Davison Ct, Lockport, NY 14094-5370 | 2006-03-23 |
| Find all providers in LOCKPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.