SearchIllinois222Q00000X

Keisha Clark

NPI 1457690844 · on the registry since 2013

Practice

Address
3711 S Vincennes Ave
Unit 614
Chicago, IL 60653
Phone
(309) 721-8831

Registry record

Primary taxonomy
222Q00000X
222Q00000X
Sex
Female
Record last updated
2013-02-05

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois