person
Jacob Clark
Medical Physician Assistant in Peoria, Illinois
NPI 1013614304

Jacob Clark is a Medical Physician Assistant based in Mcfarland, IL and is specialized in Medical. Jacob Clark practices in Peoria, IL. The NPI Number for Jacob Clark is 1013614304 and holds a License No. (Illinois).

The current practice location address for Jacob Clark is 530 Ne Glen Oak Ave, Peoria, IL and can be reached out via phone at 309-655-2000. You can also correspond with Jacob Clark through the mailing address at 4537 TUNDRA LN, MCFARLAND, WI - 53558-9158 (mailing address contact number: 605-521-8056).

Location: 530 Ne Glen Oak Ave, Peoria, IL, 53558-9158
person
Provider Profile Details
NPI Number
1013614304
Provider Name
Jacob Clark
Credential
Provider Entity Type
Individual
Gender
Male
Address
530 Ne Glen Oak Ave, Peoria, IL, 53558-9158
Phone Number
309-655-2000
Fax Number
Provider Enumeration Date
02/08/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
530 Ne Glen Oak Ave
City
State
Zip
61637-0001
Phone Number
309-655-2000
Fax Number
person
Provider Business Mailing Address Details
Address
530 Ne Glen Oak Ave
City
State
Zip
61637-0001
Phone Number
309-655-2000
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
()
Definition
Definition to come...
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