DR. ELIZABETH TALLEY CLARK M.D. R.V.T. NPI 1487646535

NPI Information

NPI: 1487646535
Provider Name: DR. ELIZABETH TALLEY CLARK, M.D., R.V.T.
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

PECOS Registration: Yes

Address:
1614 W CENTRAL RD
SUITE 100
ARLINGTON HEIGHTS, IL
ZIP 60005
Phone: (847) 577-5814
Get Directions

DR. Elizabeth Talley Clark, M.D., R.V.T. is a vascular surgery surgery in Arlington Heights, IL. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. DR. Elizabeth Talley Clark, M.D., R.V.T. NPI is 1487646535. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1614 W CENTRAL RD
SUITE 100
ARLINGTON HEIGHTS, IL
ZIP 60005-490
Phone: (847) 577-5814
Fax: (847) 577-5914

The NPI 1487646535 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/16/2005 and was last updated on 4/24/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery	036-076927	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1487646535	OTHER	ILLINOIS	NPI
2	F300151367	MEDICARE PIN	ILLINOIS
3	K08773	MEDICARE OSCAR/CERTIFICATION
4	E18362	MEDICARE UPIN
5	036-076927-1	MEDICAID	ILLINOIS
6	K08773	MEDICARE PIN
7	E18362	MEDICARE UPIN	ILLINOIS
8	357801	MEDICARE PIN	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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