Aleta V Clark in Matteson - Adolescent Medicine
Aleta V Clark - NPI 1548269814
Aleta V Clark is a Adolescent Medicine in Matteson, Illinois. Aleta V Clark practices all healthcare services and medical treatments related to Adolescent Medicine. The NPI Number for Aleta V Clark is 1548269814. The last update date is 2009-11-25.
Aleta V Clark's current location address is Po Box 189, Matteson, Illinois. You can contact this provider via phone number 7087475850 and fax number 7087479991. The mailing address for Aleta V Clark is Po Box 189, Matteson, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Aleta V Clark |
|---|---|
| Address | Po Box 189, Matteson, Illinois |
| Phone Number | 7087475850 |
| Fax Number | 7087479991 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1548269814 |
|---|---|
| Provider Enumeration Date | 2005-07-19 |
| Last Updated Date | 2009-11-25 |
Provider Mailing Address Detail
| Address | Po Box 189 |
|---|---|
| City | Matteson |
| State | Illinois (IL) |
| Post Code | 604430189 |
| Phone Number | 7087475850 |
| Fax Number | 7087479991 |
Provider's Primary Taxonomy Detail
| Speciality | Adolescent Medicine |
|---|---|
| Taxonomy | 2080A0000X |
| Licence No | 36051208 |
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Definition: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 36051208 | IL | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Aleta V Clark by the Centers for Medicare & Medicaid Services?
The Aleta V Clark has been assigned the NPI (National Provider Identifier) 1548269814 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Aleta V Clark?
The Aleta V Clark is physically situated at Po Box 189, in the city of Matteson, state of IL, with the postal code 604430189.
What is Aleta V Clark's area of expertise and its corresponding taxonomy classification?
The Aleta V Clark's field of specialization is Adolescent Medicine, and it falls under the taxonomy code 2080A0000X, which categorizes healthcare providers based on their areas of practice.
On what date was the 1548269814 assigned to Aleta V Clark?
The Aleta V Clark was issued its 1548269814 on 2005-07-19, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Aleta V Clark's details last updated?
The information pertaining to the Aleta V Clark, including its address, specialty, and other details, was most recently updated on 2009-11-25.