CLARK ANDERSON (NPI# 1447783063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447783063 |
| Entity Type | Individual |
| Full Name | CLARK ANDERSON |
| Practice Address |
19010 Avers Ave Flossmoor IL 60422-1017 |
| Practice Telephone | 7085740728 |
| Mailing Telephone | 7085740728 |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2017-04-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | IL | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104485770 | Clark Calvin Anderson | Internal Medicine | 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2019-06-07 |
| 1750460481 | Clark Anderson | Physician Assistant | 1001 Main St, Suite 500a, Peoria, IL 61606-1907 | 2006-11-03 |
| 1508816653 | Clark Anderson | Psychiatry & Neurology | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2006-05-11 |
| Street Address |
19010 AVERS AVE |
| City | FLOSSMOOR |
| State | IL |
| Zip Code | 60422-1017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274310 | Miranda Home Health Care Inc | Nursing Care | 19150 S. Kedzie Ave, 203, Flossmoor, IL 60422 | 2020-08-06 |
| 1285256172 | Bp Behavioral Services, LLC | Behavioral Analyst | 2222 Marston Lane, Flossmoor, IL 60422 | 2020-05-13 |
| 1891164133 | Lauren Simpson | Behavioral Analyst | 19530 Kezie Avenue, Flossmoor, IL 60422 | 2015-09-16 |
| 1437541190 | Keshawn Gardner | Specialist/Technologist, Other | 1248 Berry Ln, Flossmoor, IL 60422 | 2015-03-04 |
| 1770989717 | Naomi Kelly | Behavioral Analyst | 1930 Kedzie Avenue, Flossmoor, IL 60422 | 2014-11-18 |
| 1093059453 | Miranda Home Health Care Inc | In Home Supportive Care | 19150 S Kedzie Ave, 203, Flossmoor, IL 60422 | 2012-11-23 |
| 1285981506 | Restorative Life Services, LLC | Social Worker | 169624 Governors Highway, Flossmoor, IL 60422 | 2012-08-06 |
| 1063786457 | Gwyneeda Carter-sidberry | Pharmacist | 1443 Selkirk Street, Flossmoor, IL 60422 | 2012-03-02 |
| 1053682021 | Alfonso Javier Medina Sr. | Anesthesiology | 3141 Stonegate Ct., Flossmoor, IL 60422 | 2012-01-23 |
| 1912121161 | Anthony J Maoloni | Dentist | 19815 Governors Highway, Orthodontic Associates Ltd Suite 1, Flossmoor, IL 60422 | 2007-04-12 |
| Find all providers in zip 60422 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407020365 | Janetta Bell | Contractor | 3025 Monterey Dr, Flossmoor, IL 60422-2273 | 2008-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356958607 | Letisha Smith | Contractor | 1921 Michigan City Rd Apt 1e, Calumet City, IL 60409-3724 | 2020-09-29 |
| 1184249088 | Yanko I Stoykov | Contractor | 1807 W Locust Ln, Mt Prospect, IL 60056-4405 | 2020-06-16 |
| 1043844293 | S.crider Construction An Supply Corp. | Contractor | 529 Woodbridge Dr., Quincy, IL 62301 | 2020-02-26 |
| 1245864784 | Kendall Divante Leonard | Contractor | 524 N Roberts Dr Apt 2b, Glenwood, IL 60425-2300 | 2020-02-24 |
| 1477185379 | Azar Garayev | Contractor | 300 Hudson Ct Apt 106, Wheeling, IL 60090-3184 | 2020-02-07 |
| 1578031183 | Yesenia Servin | Contractor | 2 Westbrook Corporate Ctr Ste 600, Westchester, IL 60154-5716 | 2018-11-13 |
| 1194205781 | Anais J Robles | Contractor | 1626 S Allport St, Chicago, IL 60608 | 2018-08-14 |
| 1225528524 | Tara Rada Nieberding | Contractor | 1701 Quincy Ave Ste 12, Naperville, IL 60540 | 2018-05-14 |
| 1710482542 | Lanisha Blockmon | Contractor | 8214 S Evans Ave, Chicago, IL 60619-5306 | 2018-03-25 |
| 1487157913 | Stavone Mcherron | Contractor | 3420 Fountainbleau Dr, Hazel Crest, IL 60429-2257 | 2018-03-12 |
| Find all providers with the same taxonomy | ||||
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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.