Sue Clark in Peoria - Developmental - Behavioral Pediatrics
Sue Clark - NPI 1174597371
Sue Clark is a Developmental - Behavioral Pediatrics in Peoria, Illinois. Sue Clark practices all healthcare services and medical treatments related to Developmental - Behavioral Pediatrics. The NPI Number for Sue Clark is 1174597371. The last update date is 2007-07-09.
Sue Clark's current location address is 507 E Armstrong Ave, Peoria, Illinois. You can contact this provider via phone number 3096816960. The mailing address for Sue Clark is 507 E Armstrong Ave, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Sue Clark |
|---|---|
| Address | 507 E Armstrong Ave, Peoria, Illinois |
| Phone Number | 3096816960 |
| Fax Number | |
| Sole Proprietor | X |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1174597371 |
|---|---|
| Provider Enumeration Date | 2006-02-14 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 507 E Armstrong Ave |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616033201 |
| Phone Number | 3096816960 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Developmental - Behavioral Pediatrics |
|---|---|
| Taxonomy | 2080P0006X |
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Definition: A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy effort |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7215036 | IL | BCBS | |
| IL01Z4 | IL | JOHN DEERE |
Post Comment/ Review Below
What is the Sue Clark's unique identification number?
The Sue Clark has been assigned the NPI (National Provider Identifier) Number 1174597371 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete street address where Sue Clark is physically located?
The Sue Clark is physically situated at the following address: 507 E Armstrong Ave, Peoria, IL, 616033201.
What is the Sue Clark's area of specialization and corresponding taxonomy classification?
The Sue Clark's specialty field is Developmental - Behavioral Pediatrics, and it falls under the taxonomy code 2080P0006X, which categorizes healthcare providers based on their specialties.
On what date did the Sue Clark receive the assignment of its 1174597371 from the Centers for Medicare & Medicaid Services?
The Sue Clark was issued its 1174597371 by the Centers for Medicare & Medicaid Services on 2006-02-14.
When was the information related to Sue Clark most recently updated or refreshed?
The details pertaining to the Sue Clark, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-09.