MARK C CLARKE (NPI# 1366555112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366555112 |
| Entity Type | Individual |
| Full Name | MARK C CLARKE |
| Credential | MD |
| Practice Address |
2300 N Edward St Decatur IL 62526 |
| Mailing Address |
6450 Reliable Parkway Chicago IL 60686 |
| Practice Telephone | 2178765023 |
| Practice Fax Number | 2178765013 |
| Mailing Telephone | 2177883000 |
| Mailing Fax Number | 2177885577 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 0360864171 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790850584 | Mark Edward Clarke | Nurse Practitioner | 100 Clark Rd, Smithfield, RI 02917-2311 | 2006-11-21 |
| 1477513166 | Mark Anthony Clarke | Family Medicine | 731 N Clyde Morris Blvd, Daytona Beach, FL 32114-1603 | 2006-03-25 |
| 1346225695 | Mark Gregory Clarke | Family Medicine | 216 Mason Ave, Cape Charles, VA 23310-3200 | 2005-12-09 |
| Street Address |
2300 N EDWARD ST |
| City | DECATUR |
| State | IL |
| Zip Code | 62526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104829886 | Tansel Turgut | Internal Medicine | 2300 N Edward St, Ste 2400, Decatur, IL 62526-4163 | 2005-05-24 |
| 1215538004 | Jordanna Ruth Wilton | Nurse Practitioner | 2300 N Edward St, Decatur, IL 62526-4192 | 2020-11-06 |
| 1366054116 | Stephanie Nicole Blaha | Physician Assistant | 2300 N Edward St, Decatur, IL 62526-4163 | 2020-08-21 |
| 1861028193 | Angelina Marie Thomas | Nurse Anesthetist, Certified Registered | 2300 N Edward St, Decatur, IL 62526-4163 | 2020-03-18 |
| 1114550944 | Chelsey M Clark | Nurse Anesthetist, Certified Registered | 2300 N Edward St, Decatur, IL 62526-4163 | 2020-02-20 |
| 1942857735 | Jessica Oranika | Nurse Practitioner | 2300 N Edward St, Decatur, IL 62526-4163 | 2019-08-26 |
| 1003463225 | Jason Grauer | Nurse Practitioner | 2300 N Edward St, Decatur, IL 62526-4192 | 2019-08-22 |
| 1780239434 | Maggie Kaye Matthews | Nurse Practitioner | 2300 N Edward St, Decatur, IL 62526-4163 | 2019-08-08 |
| 1871052522 | Michelle Caroline Kronmiller | Nurse Practitioner | 2300 N Edward St, Decatur, IL 62526-4163 | 2019-03-12 |
| 1013474097 | Brittney L Jeffery | Nurse Anesthetist, Certified Registered | 2300 N Edward St, Decatur, IL 62526-4163 | 2019-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679891311 | Cindy Mei Chy Hsieh | Pathology | 1800 E. Lake Shore Drive, Decatur, IL 62521-4839 | 2010-05-05 |
| 1952314627 | Elizabeth W Jones | Pathology | 2300 N Edward Street, Decatur, IL 62526 | 2006-08-14 |
| 1922014455 | David Martin Johnson | Pathology | 2300 N Edward Str, Decatur, IL 62526 | 2006-08-01 |
| 1063426526 | Robert Kevin Harrell | Pathology | 428 Winn Ct, Decatur, GA 30030-1726 | 2006-07-28 |
| 1417907890 | Vijay Alluri Varma | Pathology | Va Medical Center Lab Services, 1670 Clairmont Rd., Decatur, GA 30033 | 2006-05-10 |
| 1376504365 | Sue A Strayer | Pathology | 1800 E Lake Shore Drive, St Marys-decatur, Decatur, IL 62521-3883 | 2006-03-29 |
| 1013335074 | Shannon Marie O'brien | Pathology | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2014-04-06 |
| 1356607998 | Tesha Ann Guillory | Pathology | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2012-04-09 |
| 1386930832 | Lora Darrisaw | Pathology | 3121 Panthersville Rd, Decatur, GA 30034-3830 | 2011-06-23 |
| 1861678468 | Jigna C Jani | Pathology | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2008-01-14 |
| Find all providers in DECATUR | ||||
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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.