Individual provider · Type 1 NPI

Michala Eileen Clark, DO

Student in an Organized Health Care Education/Training Program · Peoria, IL

NPI number 1730973876 Active

Practice location

815 Main St Ste C
Peoria, IL 61602-1080

Call (309) 672-4977 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X00000000000000000000 (IL)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1730973876

Michala Eileen Clark, DO's National Provider Identifier is 1730973876, issued on Apr 5, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Peoria, IL. The record was last updated on Apr 5, 2025.