MR. STEVEN J CLARK (NPI# 1154353720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154353720 |
| Entity Type | Individual |
| Full Name | MR. STEVEN J CLARK |
| Credential | MD |
| Practice Address |
2 Good Samaritan Way Suite 235 Mount Vernon IL 62864-2408 |
| Practice Telephone | 6188993980 |
| Practice Fax Number | 6188994793 |
| Mailing Telephone | 6188993980 |
| Mailing Fax Number | 6188994793 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2013-10-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
036086955 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 257001700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669021564 | Steven Michael Clark | Dentist | 1700 University Blvd Ste 105, Morrilton, AR 72110-8004 | 2019-09-04 |
| 1801079686 | Steven Shia Clark | Social Worker | 223 Gratiot Ct, Saginaw, MI 48602-1865 | 2007-12-14 |
| 1003982489 | Steven Clark | Occupational Therapist | 15311 Vantage Pkwy W Ste 130, Houston, TX 77032-1955 | 2006-11-28 |
| 1124125505 | Steven Lester Clark | Family Medicine | 4586 E Highway 20, Suite B, Niceville, FL 32578-9724 | 2006-09-20 |
| 1023114576 | Steven Donald Clark | Physical Therapist | 2220 Mormon Trek Blvd, Iowa City, IA 52246-4435 | 2006-09-15 |
| 1629172622 | Steven Heyen Clark | Dentist | 801 Newton Ave, Iowa City, IA 52242-1001 | 2006-09-11 |
| 1124036058 | Steven Alan Clark | Chiropractor | 2747 Sunset Ave, Rocky Mount, NC 27804-3751 | 2006-08-04 |
| 1063414464 | Steven R. Clark | Physical Therapist | 330 1st Street, Suite 100, Steven Clark Mfr Physical Therapy, West Des Moines, IA 50265 | 2005-08-15 |
| 1861498859 | Steven D. Clark | Physician Assistant | 14 Mountain Ledge Drive, Wilton, NY 12831-1858 | 2005-06-23 |
| 1881252658 | Steven Douglas Clark | Physician Assistant | 1998 Motel Blvd, Las Cruces, NM 88007 | 2019-06-05 |
| Street Address |
2 GOOD SAMARITAN WAY SUITE 235 |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-2408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718900 | Ssm Health Businesses | Hospice Care, Community Based | 2 Good Samaritan Way, Suite 325, Mount Vernon, IL 62864-2408 | 2005-05-24 |
| 1417573734 | Scherrie Lynn Medina | Registered Nurse | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2020-06-23 |
| 1245711779 | Mary K Mcgarvey | Occupational Therapy Assistant | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2018-08-23 |
| 1831611334 | Patricia Isabel Calcetto | Nurse Anesthetist, Certified Registered | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2017-07-17 |
| 1821548207 | Nicole Vetter | Nurse Practitioner | 2 Good Samaritan Way, Medical Plaza Suite 420, Mount Vernon, IL 62864-2408 | 2016-10-10 |
| 1740654821 | Kathryn Flanigan | Speech-Language Pathologist | 2 Good Samaritan Way, 3rd Floor, Mount Vernon, IL 62864-2408 | 2015-11-30 |
| 1275900656 | Christopher Bourget | Registered Nurse | 2 Good Samaritan Way, Medical Plaza Suite 205, Mount Vernon, IL 62864-2408 | 2015-09-01 |
| 1992188338 | Carl Robert Davis | Nurse Anesthetist, Certified Registered | 2 Good Samaritan Way, Suite 205, Mount Vernon, IL 62864-2408 | 2015-07-02 |
| 1871919845 | Michell R Ellis | Pharmacist | 2 Good Samaritan Way, Suite 120, Mount Vernon, IL 62864-2408 | 2014-03-13 |
| 1548685647 | Rebecca Breanne Ritchey | Speech-Language Pathologist | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2014-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235280579 | David Lawrence Brabon | Surgery | 140 Newcomb Ave, Mount Vernon, KY 40456-2728 | 2007-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074617 | Dewolfe Aesthetic Services Sc | Surgery | 3357 N. Southport Aveune, Chicago, IL 60657 | 2020-05-11 |
| 1578068524 | Jw Operatory | Surgery | 1811 Saint Johns Ave Ste 100, Highland Park, IL 60035-5607 | 2018-03-29 |
| 1780198796 | Lin Plastic and Reconstructive Surgery Inc | Surgery | 730 W Couch Pl Unit 1409, Chicago, IL 60661-1383 | 2017-11-29 |
| 1750892923 | Alban Ingram Miller Jr. | Surgery | 1708 Foxborough Ct, Champaign, IL 61822-8503 | 2017-10-16 |
| 1972905545 | Jennifer Hein | Surgery | 2631 Williamsburg Ave Ste 102, Geneva, IL 60134-1108 | 2014-09-25 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1043559842 | Msa Alliance, LLC | Surgery | 1 Broadway Plz, Sparta, IL 62286-1800 | 2013-02-14 |
| 1518223791 | Hansel M Debartolo Jr Md Sc | Surgery | 11 Debartolo Dr., Sugar Grove, IL 60554 | 2012-04-02 |
| 1952692717 | Georgios Kokosis | Surgery | 1725 W Harrison St Ste 425, Chicago, IL 60612-3893 | 2011-04-28 |
| 1740596808 | Swedishamerican Hospital | Surgery | 6533 Lexus Dr, Rockford, IL 61108 | 2010-08-27 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
Please comment or provide details below to improve the information on MR. STEVEN J CLARK.
| 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.