PATRICIA CLARK MD LLC (NPI# 1134477169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134477169 |
| Entity Type | Organization |
| Organization Name | PATRICIA CLARK MD LLC |
| Practice Address |
12701 W 143rd St Homer Glen IL 60491-7715 |
| Mailing Address |
Po Box 379 Orland Park IL 60462-0379 |
| Practice Telephone | 8158463358 |
| Practice Fax Number | 7084601117 |
| Mailing Telephone | 7084609833 |
| Mailing Fax Number | 7084601117 |
| Enumeration Date | 2012-08-23 |
| Last Update Date | 2012-08-23 |
| Authorized Official Name | DR. PATRICIA L CLARK (PRESIDENT) |
| Authorized Official Telephone | 7084609833 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 03611578 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
12701 W 143RD ST |
| City | HOMER GLEN |
| State | IL |
| Zip Code | 60491-7715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821097882 | Roseann M Horan | Family Medicine | 12701 W 143rd St, Ste 230, Homer Glen, IL 60491-7715 | 2005-07-20 |
| 1356661680 | Daniel Alexander Baluch | Orthopaedic Surgery | 12701 W 143rd St, Ste 200, Homer Glen, IL 60491-7715 | 2010-06-09 |
| 1891011490 | Matthew Peahl Dc Sc | Rehabilitation Unit | 12701 W 143rd St, Suite 110, Homer Glen, IL 60491-7715 | 2010-04-08 |
| 1942432380 | Jason Welsch | Physician Assistant | 12701 W 143rd St, Suite 200, Homer Glen, IL 60491-7715 | 2009-08-19 |
| 1689841314 | Krzysztof B Siemionow | Orthopaedic Surgery | 12701 W 143rd St, Suite 200, Homer Glen, IL 60491-7715 | 2008-05-12 |
| 1548448681 | O'connor Medical LLC | Internal Medicine | 12701 W 143rd St, Homer Glen, IL 60491-7808 | 2008-01-31 |
| 1568649838 | Homer Glen Pediatrics, Sc | Pediatrics | 12701 W 143rd St, Homer Glen, IL 60491-7808 | 2008-01-29 |
| 1770772006 | Thomas J Vasdekas, M.d. | Surgery | 12701 W 143rd St, Suite 110, Homer Glen, IL 60491-7715 | 2007-10-23 |
| 1659408821 | Jean M. Garbolski Do Sc | Family Medicine | 12701 W 143rd St, Homer Glen, IL 60491-7808 | 2007-02-27 |
| 1578602066 | Homer-lockport Dental Associates, Inc. | Dentist | 12701 W 143rd St, Homer Glen, IL 60491-7808 | 2007-02-05 |
| Find all providers in the same location | ||||
| 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 |
| 1093893117 | Daniel L Clark Do Ltd | Family Medicine | 14831 W 159th St, Harris Bank Building, Lockport, IL 60491 | 2006-11-02 |
| 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 |
| Find all providers in zip 60491 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952675365 | Maria Teresa Rapciak | Surgery | 12701 W 143rd St Ste 110, Homer Glen, IL 60491-7721 | 2012-03-02 |
| 1740701952 | Advanced Surgical Consultants LLC | Surgery | 12701 W 143rd St Ste 110, Homer Glen, IL 60491-7721 | 2017-06-28 |
| 1770772006 | Thomas J Vasdekas, M.d. | Surgery | 12701 W 143rd St, Suite 110, Homer Glen, IL 60491-7715 | 2007-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1376167809 | Francesco Bajani | Surgery | 664 N Dearborn St Apt 2f, Chicago, IL 60654-3848 | 2020-06-01 |
| 1972123099 | Andrea Liu | Surgery | 5841 S Maryland Ave Mc6040, Chicago, IL 60637-1443 | 2020-04-18 |
| 1750917183 | Alberto Maria Fratti | Surgery | 901 S Ashland Ave Apt 711, Chicago, IL 60607-4088 | 2020-03-17 |
| 1841845047 | Barijuve Surgical LLC | Surgery | 380 E Northwest Hwy Ste 200, Des Plaines, IL 60016-2274 | 2019-08-05 |
| 1164081782 | Sean Park | Surgery | 1739 Tudor Ln Unit 308, Northbrook, IL 60062-3778 | 2019-06-07 |
| 1376014175 | Edwardsville Physicians Group LLC | Surgery | 441 South State Route 157 Suite 102, Edwardsville, IL 62025-4012 | 2018-12-06 |
| 1316421324 | Erica Lester | Surgery | John H Stroger, 1969 Ogden Ave, Chicago, IL 60612 | 2018-09-17 |
| 1023513389 | Crystal Siyu Zhang | Surgery | 2160 S 1st Ave Bldg 3210, Maywood, IL 60153 | 2018-03-28 |
| 1376047381 | Richard Lawrence Nelson | Surgery | 1603 W. Taylor St., Room 983, Chicago, IL 60612-4394 | 2018-03-23 |
| Find all providers with the same taxonomy | ||||
| City | HOMER GLEN |
| Zip Code | 60491 |
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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.