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JOSEPH I CLARK MD NPI 1972580843


NPI Information

NPI: 1972580843
Provider Name: JOSEPH I CLARK, MD
Classification: Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

Organization: LOYOLA UNIVERSITY MEDICAL CENTER

PECOS Registration: Yes

Address:
2160 S FIRST AVE
LUH-NORTH ENT., RM. 7604
MAYWOOD, IL
ZIP 60153
Phone: (708) 216-3304
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Joseph I Clark, MD is a hematology and oncology internal medicine in Maywood, IL with 35 years of experience. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. Joseph I Clark, MD NPI is 1972580843. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduation Year:1989

The provider's business location address is:

2160 S FIRST AVE
LUH-NORTH ENT., RM. 7604
MAYWOOD, IL
ZIP 60153
Phone: (708) 216-3304
Fax: (708) 216-1259

The NPI 1972580843 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/30/2005 and was last updated on 1/28/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & Oncology36083048ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
136083048MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.