Individual provider · Type 1 NPI

Kyle R. Clark, PA-C

Physician Assistant · Rockford, IL

NPI number 1801415864 Active

Practice location

5666 E State St
Rockford, IL 61108-2425

Call (815) 226-2000 Map

Mailing address

1395 Jay St
Freeport, IL 61032-8424

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X085.007488 (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 1801415864

Kyle R. Clark, PA-C's National Provider Identifier is 1801415864, issued on Apr 10, 2020. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Rockford, IL. The record was last updated on Apr 10, 2020.