Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CLINTON LARISCY, IDC
Active Sole ProprietorIndependent Duty Corpsman · GREAT LAKES, IL
Registration Details
- NPI Number
- 1164736302
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 29, 2010 (15.760875308677 yrs)
- Last Updated
- Jul 29, 2010
- Sole Proprietor
- Yes
Practice Information
- Address
-
3355 ILLINOIS STRECRUIT TRAINING COMMAND GREAT LAKESGREAT LAKES, IL, 60088Browse IL providers · Browse ZIP 60088
- Phone
- 8476884643
- Primary Specialty
-
Independent Duty Corpsman
1710I1002X
Other Independent Duty Corpsman Providers in GREAT LAKES, IL
| Name | Credential | NPI |
|---|---|---|
| MR. DAVID ROBERT JOHNSEN | NAVY IDC | 1467420422 |
| MR. RODGER M HOWARD | IDC | 1205804242 |
| MR. CLIFFORD LOREN MOUDY II | I.D.C. | 1679541676 |
| MR. JOSEPH ALAN BURMEISTER | IDC | 1235199399 |
| JOSE ALFREDO NICOLA | IDC | 1205891256 |
| MR. RAYMOND LAWRENCE HOWARD SR. | — | 1366502858 |
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.