Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JOHN RILEY CLARK, PA-C
Active Sole ProprietorMR. JOHN RILEY CLARK, PA-C is a Medical Physician Assistant healthcare provider located in OSWEGO, Illinois. NPI 1063072973 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · OSWEGO, IL
Registration Details
- NPI Number
- 1063072973
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 13, 2019 (7.208067106947 yrs)
- Last Updated
- Aug 2, 2019
- License
-
085.007136 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2700 LIGHT RD APT 102OSWEGO, IL, 605439231Browse IL providers · Browse ZIP 60543
- Phone
- 4155168668
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.