MRS. DEBRA ANN CLARK (NPI# 1508079328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508079328 |
| Entity Type | Individual |
| Full Name | MRS. DEBRA ANN CLARK |
| Credential | RN |
| Practice Address |
2044 Madison Ave Suite G7 Granite City IL 62040-4641 |
| Practice Telephone | 6184516685 |
| Practice Fax Number | 6184517292 |
| Mailing Telephone | 6184516685 |
| Mailing Fax Number | 6184517292 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0200X |
Registered Nurse Specialization: Pediatrics |
IL | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336525625 | Debra Clark | Nurse Practitioner | 1040 Vinehaven Dr Ne, Concord, NC 28025-2438 | 2015-08-10 |
| 1255683330 | Debra Ashley Clark | Audiologist | 1720 Peachtree St Nw Ste 200, Atlanta, GA 30309-2440 | 2012-10-12 |
| 1871816041 | Debra Striler Clark | Psychologist | 71 Walnut, Suite 109, Rochester, MI 48307-2073 | 2010-03-02 |
| 1952539785 | Debra Diane Clark | Reflexologist | 104 53rd Ave E, Bradenton, FL 34203-4702 | 2009-07-01 |
| 1720178650 | Debra Sue Clark | Physical Therapist | 3500 S Boulevard, Suite A, Edmond, OK 73013-5490 | 2006-10-13 |
| 1609896943 | Debra Jean Clark | Counselor | 10 Market St, Suite 5, Oneonta, NY 13820-2655 | 2006-07-20 |
| 1962473397 | Debra Clark | Family Medicine | 1409 Rt 9, Keeseville, NY 12944-2845 | 2006-02-01 |
| 1154665669 | Debra Mae Clark | Physical Therapy Assistant | 1502 E Centennial Dr, Pittsburg, KS 66762-6718 | 2012-11-21 |
| 1407144215 | Debra Lou Clark | Counselor | 3 Bridge St, Carthage, NY 13619-1353 | 2011-07-13 |
| 1790003218 | Debra Lynn Ann Clark | Licensed Practical Nurse | 116 Second St, Greenland, MI 49929 | 2010-05-07 |
| Street Address |
2044 MADISON AVE SUITE G7 |
| City | GRANITE CITY |
| State | IL |
| Zip Code | 62040-4641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851383301 | Michael C Adams | Internal Medicine | 2044 Madison Ave, Suite 15, Granite City, IL 62040-4641 | 2005-08-19 |
| 1316366594 | Biomedical Imaging, LLC | Physiological Laboratory | 2044 Madison Ave, Suite 28, Granite City, IL 62040-4641 | 2014-04-15 |
| 1922233576 | Elizabeth Patricia Mincy | Nurse Practitioner | 2044 Madison Ave, Suite 15, Granite City, IL 62040-4641 | 2009-05-27 |
| 1528222437 | Paul Joseph Pace | Surgery | 2044 Madison Ave, Suite 27, Granite City, IL 62040-4641 | 2008-07-10 |
| 1023292000 | Granite City Orthopedic Physicians Company LLC | Durable Medical Equipment & Medical Supplies | 2044 Madison Ave, Granite City, IL 62040-4641 | 2007-12-26 |
| 1487847638 | Fairview Heights Medical Group Sc | Urology | 2044 Madison Ave, Suite 15, Granite City, IL 62040-4641 | 2007-08-21 |
| 1508983214 | Granite City Physicians Corp | Clinical Medical Laboratory | 2044 Madison Ave, Suite 15, Granite City, IL 62040-4641 | 2007-03-26 |
| 1184741142 | Bijoy Hegde Md, PC | Physical Medicine & Rehabilitation | 2044 Madison Ave, Suite 15, Granite City, IL 62040-4641 | 2007-03-23 |
| 1710036025 | Irmady Bijoy Hegde | Physical Medicine & Rehabilitation | 2044 Madison Ave, Suite 15, Granite City, IL 62040-4641 | 2007-01-09 |
| 1134217169 | John R Williams Jr. | Surgery | 2044 Madison Ave, Suite 27, Granite City, IL 62040-4641 | 2006-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043736705 | Christine S Bieniecki Canada | Speech-Language Pathologist | 2300 West 25th St, Granite City, IL 62040 | 2017-08-15 |
| 1881085819 | James Watson | Counselor | 50 Northgate Industrial Drive, Granite City, IL 62040 | 2015-02-12 |
| 1518208719 | Chestnut Health Systems | Clinic/Center | 110 Northagte Industrial Drive, Granite City, IL 62040 | 2013-03-13 |
| 1952651697 | Victor Manuel Pinones | Dentist | 2130 Johnson Rd., Granite City, IL 62040 | 2012-09-10 |
| 1427360502 | Erin K Boerm | Occupational Therapist | 3540 Village Lane, Granite City, IL 62040 | 2010-07-06 |
| 1659503027 | Toni Lyn Siler | Counselor | 101 Whitsell Way, Apt 102, Pontoon Beach, IL 62040 | 2009-08-18 |
| 1871741462 | Fountain View Manor LLC | Alzheimer Center (Dementia Center) | 3432 Village Lane, Granite City, IL 62040 | 2008-09-08 |
| 1083880595 | Christina Marie Darin | Chiropractor | 2013 Johnson Road, Suite C & D, Granite City, IL 62040 | 2008-05-05 |
| 1629244322 | Julia Elaine Uhring Green | Counselor | 2429 Washinton Ave, Granite City, IL 62040 | 2008-05-02 |
| 1578786117 | John K Parker | Preventive Medicine | Veeder Health Center, 20th and Iowa, Granite City, IL 62040 | 2007-04-11 |
| Find all providers in zip 62040 | ||||
| Taxonomy Code | 163WP0200X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833047 | Jennifer Fay Herbert | Registered Nurse | 4011 N Francisco Ave Unit 111, Chicago, IL 60618-2655 | 2020-08-28 |
| 1225653082 | Kailin Haugh | Registered Nurse | 194 Ivy Ln, Bloomingdale, IL 60108-1726 | 2020-06-08 |
| 1841819828 | Alison Chesniak Thompson | Registered Nurse | 1857 W Diversey Pkwy Apt 301, Chicago, IL 60614-9236 | 2020-04-10 |
| 1962038935 | Wendy Lankenau | Registered Nurse | 225 E Chicago Ave Unit A, Chicago, IL 60611-2991 | 2020-03-21 |
| 1720594013 | Viktoria Mileva | Registered Nurse | 236 Tallman Ave, Romeoville, IL 60446-1746 | 2017-12-21 |
| 1205268612 | Precious Watson | Registered Nurse | 1217 E 95th St, Chicago, IL 60619-8019 | 2013-08-08 |
| 1679721633 | Cynthia L. Booth | Registered Nurse | 1801 W Taylor St # 2e, Children and Adolescent Center, Chicago, IL 60612-4319 | 2008-09-03 |
| 1942458260 | Sarah E Kelso | Registered Nurse | 4611 Golf Rd, Suite 200, Skokie, IL 60076-1209 | 2008-08-28 |
| 1295938645 | Marykay Petges | Registered Nurse | 101 Birch Dr Sw, Poplar Grove, IL 61065-8962 | 2007-06-05 |
| 1841410289 | Maureen Adele Macmillan-brown | Registered Nurse | 7028 N Ozark Ave, Chicago, IL 60631-1064 | 2007-04-26 |
| Find all providers with the same taxonomy | ||||
| City | GRANITE CITY |
| Zip Code | 62040 |
Please comment or provide details below to improve the information on MRS. DEBRA ANN 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.