Healthcare Provider Details

I. General information

NPI: 1528095379
Provider Name (Legal Business Name): FRANK MILO CLARK M.D., PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE EVANSTON HOSPITAL
EVANSTON IL
60201-1718
US

IV. Provider business mailing address

2650 RIDGE AVE EVANTON HOSPITAL
EVANSTON IL
60201-1718
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-1206
  • Fax: 847-570-1248
Mailing address:
  • Phone: 847-570-1206
  • Fax: 847-570-1248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036097575
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number036097575
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: