STEPHANIE CLARK (NPI# 1760969588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760969588 |
| Entity Type | Individual |
| Full Name | STEPHANIE CLARK |
| Credential | LCPC |
| Practice Address |
5453 W Diversey Ave Chicago IL 60639-1413 |
| Practice Telephone | 7735649070 |
| Mailing Telephone | 7735649070 |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2018-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180.010831 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922612605 | Stephanie Clark | Massage Therapist | 15227 Spring Cor, San Antonio, TX 78247-1693 | 2020-09-01 |
| 1811516156 | Stephanie Clark | Social Worker | 10185 Isle St, Parker, CO 80134-5788 | 2020-04-15 |
| 1306486444 | Stephanie Clark | Licensed Practical Nurse | 636 Clay Ave Uppr, Rochester, NY 14613-1030 | 2020-01-07 |
| 1841681046 | Stephanie Clark | Technician, Other | 2917 S Ash Ct, Broken Arrow, OK 74012-7804 | 2015-02-09 |
| 1760816326 | Stephanie Diane Clark | Case Manager/Care Coordinator | 4613 Se 41st St, Del City, OK 73115-3703 | 2013-08-30 |
| 1538447560 | Stephanie Renae Clark | Physical Therapist | 927 Battlefield Blvd N, Suite 200, Chesapeake, VA 23320-4853 | 2011-07-25 |
| 1932330545 | Stephanie D Clark | Social Worker | 16581 Us Highway 17 N Ste 600, Hampstead, NC 28443-7451 | 2009-07-30 |
| 1487719787 | Stephanie Clark | Licensed Practical Nurse | 55 Ramble Hill Lane, Millbrook, NY 12545 | 2006-12-27 |
| 1811057425 | Stephanie Clark | Dentist | 7601 A Germantown Ave, Philadelphia, PA 19119 | 2006-12-12 |
| 1700864733 | Stephanie Elaine Clark | Audiologist | 13934 N 59th Ave, Ste 120, Glendale, AZ 85306-4167 | 2006-01-09 |
| Street Address |
5453 W DIVERSEY AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60639-1413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003232034 | Rincon Family Services | Clinic/Center | 5453 W Diversey Ave, Chicago, IL 60639-1413 | 2014-03-14 |
| 1558710384 | Rincon Family Services | Clinic/Center | 5453 W Diversey Ave, Chicago, IL 60639-1413 | 2016-06-13 |
| 1093164824 | Rincon Family Services | Clinic/Center | 5453 W Diversey Ave, Chicago, IL 60639-1413 | 2016-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293801 | Wh Il Dental Pllc | Dentist | 18086 N. Kilpatrick Ave., Chicago, IL 60639 | 2020-10-21 |
| 1568012375 | Ellen E Cox | Physical Therapist | 4369 W Diversey Ave, Chicago, IL 60639 | 2019-09-13 |
| 1306379268 | Michael Duarte | Family Medicine | 4417 W Diversey Ave, Chicago, IL 60639 | 2017-04-07 |
| 1013464593 | Ismile Dental | Dentist | 4953 West Fullerton Ave, Chicago, IL 60639 | 2016-09-01 |
| 1952773566 | Flor Cortes | Pharmacist | 4626 W Diversey, Chicago, IL 60639 | 2015-10-22 |
| 1205178654 | The Head Injury Center for Prevention and Community | Case Management | 1732 N. Narragansett Ave, Chicago, IL 60639 | 2013-03-25 |
| 1013299262 | Aamer Arboleda | Pharmacist | 1606 N. Mobile Ave., Chicago, IL 60639 | 2011-09-14 |
| 1295037927 | Mary Veronica Galiotto | Pharmacist | 2920 N Narragansett, Chicago, IL 60639 | 2010-12-01 |
| 1295067478 | Galileo Optical Co. | Eyewear Supplier (Equipment, not the service) | 5759 W. Fullerton, Chicago, IL 60639 | 2010-02-12 |
| 1831424548 | Sonrisa Family Dental At The Hall, P.C. | Dentist | 4608 A & B West Diversey Avenue, Chicago, IL 60639 | 2009-10-14 |
| Find all providers in zip 60639 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477579 | Shantrell Patrice Sutton | Counselor | 5042 W Erie St, Chicago, IL 60644-1604 | 2020-11-05 |
| 1073114591 | Alternative Schools Network | Counselor | 1807 W Sunnyside Ave, Chicago, IL 60640-5898 | 2020-11-02 |
| 1992306518 | Gravity and Grace Psychotherapy, Pllc | Counselor | 1305 S Michigan Ave Apt 602, Chicago, IL 60605-3398 | 2020-11-02 |
| 1811597263 | April Wilburne | Counselor | 804 E 54th St Apt 3, Chicago, IL 60615-4972 | 2020-10-27 |
| 1043810393 | Pamela Kranyak | Counselor | 30 N Michigan Ave Ste 925, Chicago, IL 60602-3463 | 2020-10-27 |
| 1003413378 | Erika Aguirre | Counselor | 5040 S Keating Ave., Chicago, IL 60632-4919 | 2020-10-08 |
| 1497361661 | Michael V Biederman | Counselor | 4254 N Mozart St Apt 2s, Chicago, IL 60618-1784 | 2020-09-22 |
| 1013523984 | Antionette Fisher | Counselor | 5703 S Peoria St, Chicago, IL 60621-2262 | 2020-09-16 |
| 1114532561 | Nefesh Counseling, LLC | Counselor | 3320 W Foster Ave # 124, Chicago, IL 60625-4813 | 2020-09-12 |
| 1114531043 | Katherine E Evans | Counselor | 1528 W Jonquil Ter Unit 2c, Chicago, IL 60626-5932 | 2020-09-08 |
| Find all providers in CHICAGO | ||||
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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.