DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: DR. KASANDRIA CLARK MD

MEDICARE: DR. KASANDRIA CLARK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2208000000XPediatrics Physician036172412IL

General Provider Information

NPI Number : 1801538251
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KASANDRIA CLARK MD
Provider Business Mailing Address
First Line : 4104 N WESTERN AVE APT 3N
Second Line :
City : CHICAGO
State : IL
Zip : 60618-2848
Country : US
Telephone Number : 618-558-4233
Fax Number :
Provider Business Practice Location Address
First Line : 1555 W HOWARD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60626-1707
Country : US
Telephone Number : 773-764-7146
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2022
Last Update Date : 06/09/2025

Similar Medicare Providers

1588614218 — FRANCES LOCKE-ROSENBERG CNM
Practice Location Address:
1555 W HOWARD ST
CHICAGO, IL
60626-1707
Practice Phone: 773-764-7146
Practice Fax: 773-764-3774
1710931621 — NIRMLA VERMA MD
Practice Location Address:
1555 W HOWARD ST
CHICAGO, IL
60626-1707
Practice Phone: 773-764-7146
Practice Fax: 773-764-3774
1982783338 — ACCESS COMMUNITY HEALTH NETWORK
Practice Location Address:
1555 W HOWARD ST
CHICAGO, IL
60626-1707
Practice Phone: 773-764-7146
Practice Fax:
1932265907 — COMMUNITY PHARMACY SERVICES INC
Practice Location Address:
1555 W HOWARD ST
CHICAGO, IL
60626-1707
Practice Phone: 773-262-4140
Practice Fax: 773-262-4143
1679801476 — DR. NKEIRUKA O. DARA M.D.
Practice Location Address:
1555 W HOWARD ST
CHICAGO, IL
60626-1707
Practice Phone: 773-265-0300
Practice Fax: 773-265-8467
1225876816 — CHELSEA ANN SCHROEDER-LOZADA DNP, FNP-BC
Practice Location Address:
1555 W HOWARD ST
CHICAGO, IL
60626-1707
Practice Phone: 773-764-7146
Practice Fax: 773-764-3774

Directions to “ DR. KASANDRIA CLARK MD” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.