Individual provider · Type 1 NPI

Kilmeny Clark

Physician Assistant · Bloomington, IL

NPI number 1104443258 Active

Practice location

3024 E Empire St
Bloomington, IL 61704-5402

Call (309) 556-7556 Map

Fax (309) 556-7551

Mailing address

611 W Park St, Fapc
Urbana, IL 61801-2500

Other practice locations

  • 300 W Oak St, Carbondale, IL 62901-1400 · (618) 453-8850

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X5318-23 (WI)
Physician Assistant Primary 363A00000X085.008097 (IL)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1104443258

Kilmeny Clark's National Provider Identifier is 1104443258, issued on Jul 5, 2020. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Bloomington, IL. The record was last updated on Jun 9, 2025.