Whalio Doctors

NPI 1073504767

Todd Clark, MEDICALDOCTOR

Practitioner Emergency Medicine Physician Park Ridge, IL

Practice location

Address
1775 W Dempster St 1 West, Park Ridge, IL 60068-1143
Phone
(847) 723-5150
Fax
(847) 723-2083
Mailing address
29373 Network Pl, Chicago, IL 60673-1143

Registered specialties (4)

Emergency Medicine Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 207P00000X Licence 036-107180 (IL)
Emergency Medicine Physician
Allopathic & Osteopathic Physicians Taxonomy 207P00000X Licence A84896 (CA)
Emergency Medical Services (Emergency Medicine) Physician
Allopathic & Osteopathic Physicians Taxonomy 207PE0004X Licence A84896 (CA)
Emergency Medical Services (Emergency Medicine) Physician
Allopathic & Osteopathic Physicians Taxonomy 207PE0004X Licence 036-107180 (IL)

Registry record

NPI
1073504767
Entity type
Individual
Sex (as registered)
Male
NPI issued
2 Nov 2005
Record last updated
19 Sep 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.