Individual provider · Type 1 NPI
John Riley Clark, PA-C
Medical Physician Assistant · Oswego, IL
NPI number
1063072973
Active
Practice location
2700 Light Rd Apt 102
Oswego, IL 60543-9231
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 085.007136 (IL) |
Medical Physician Assistant: Definition to come...
About NPI 1063072973
John Riley Clark, PA-C's National Provider Identifier is 1063072973, issued on Jun 13, 2019. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Oswego, IL. The record was last updated on Aug 2, 2019.