Kimberly Nicole Clark, MMS, PA-C

Physician Assistant · Elgin, IL

Individual Active NPI

NPI number 1720624166

Practice location

1600 N Randall Rd Ste 400
Elgin, IL 60123-7805
Phone
(847) 381-8899

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NPI record

NPI
1720624166
Entity type
Individual (Type 1)
Enumeration date
November 20, 2019
Last updated
December 16, 2021
Certified
December 16, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 085.007399 IL

Mailing address

0n331 Ethel St
Winfield, IL 60190-1051
Phone
(630) 890-2775

About Kimberly Clark

Kimberly Nicole Clark, MMS, PA-C is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 1600 N Randall Rd Ste 400, Elgin, IL 60123-7805. The NPI number 1720624166 was assigned on November 20, 2019 and the record was last updated on December 16, 2021.

Kimberly Clark lists a license in the registry: #085.007399 (IL) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kimberly Nicole Clark, MMS, PA-C?

The NPI number is 1720624166.

What is the phone number of Kimberly Clark?

The phone number listed for the practice location is (847) 381-8899.

Where is Kimberly Clark located?

1600 N Randall Rd Ste 400, Elgin, IL 60123-7805.

What is the taxonomy code for Kimberly Clark?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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