CRYSTAL S CLARK


Address: 1000 Medical Center Dr, Monticello, IL 61856-2116
Phone: 2177626241

CRYSTAL S CLARK (NPI# 1427557321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1427557321
Entity Type Individual
Full Name CRYSTAL S CLARK
Practice Address 1000 Medical Center Dr
Monticello
IL 61856-2116
Practice Telephone 2177626241
Practice Fax Number 2177621702
Mailing Telephone 2177626241
Mailing Fax Number 2177621702
Enumeration Date 2018-02-06
Last Update Date 2019-03-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 209017069 IL Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
819 Bloomington Rd, Champaign, IL 618202101 2173561558

Other Providers CRYSTAL CLARK

NPI Name Taxonomy Address Enumeration
1619581311 Crystal Clark Massage Therapist 12506 Ne 4th Ave Apt 101, North Miami, FL 33161-4668 2020-09-01
1366068470 Crystal Sherase Clark Technician 4429 Grant St Ne, Washington, DC 20019-4739 2020-06-24
1467014894 Crystal Clark Chore Provider 153 Brambury Dr Apt D, Rochester, NY 14621-1820 2019-07-06
1386112050 Crystal Lynn Clark Internal Medicine 12056 224th St, Cambria Heights, NY 11411-2141 2018-11-11
1154898179 Crystal B Clark Family Medicine 112 Woodland Drive, Lancaster, SC 29720 2018-10-29
1801259619 Crystal Clark Technician, Other 3400 State St # 750, Salem, OR 97301-5861 2016-03-30
1467829911 Crystal Lynn Clark Specialist/Technologist 1500 Manley St, Dalton High School, Dalton, GA 30720-4088 2015-08-31
1386073070 Crystal Shawn Clark Nurse Anesthetist, Certified Registered 240 W Sugar Loaf Rd, Tucson, AZ 85737-3756 2013-11-04
1417391160 Crystal Joan Clark Nurse Practitioner 11930 Arbor St Ste 200, Omaha, NE 68144-2998 2013-04-24
1952677700 Crystal Nache Clark Counselor 13902 Sage Thrasher Lane, Riverview, FL 33579 2012-03-27

Office Location

Street Address 1000 MEDICAL CENTER DR
City MONTICELLO
State IL
Zip Code 61856-2116

Providers in the same location

NPI Name Taxonomy Address Enumeration
1376534420 James E Manint Family Medicine 1000 Medical Center Dr, Monticello, IL 61856-2116 2005-10-28
1477163434 Kristin Marie Schmidt Dietitian, Registered 1000 Medical Center Dr, Monticello, IL 61856-2116 2020-08-05
1437711140 Kirby Medical Center Pharmacy 1000 Medical Center Dr, Monticello, IL 61856-2116 2019-07-02
1407360530 Jennifer Shawn Mahannah Nurse Practitioner 1000 Medical Center Dr, Monticello, IL 61856-2116 2017-11-28
1457896623 Jennifer N Meinhart Nurse Practitioner 1000 Medical Center Dr, Monticello, IL 61856-2116 2016-12-27
1811439375 Samantha Lendi Physical Therapist 1000 Medical Center Dr, Monticello, IL 61856-2116 2016-11-14
1710343330 Santia Fitzpatrick Nurse Practitioner 1000 Medical Center Dr, Monticello, IL 61856-2116 2016-01-12
1518338532 Kathleen Quinn Dietitian, Registered 1000 Medical Center Dr, Monticello, IL 61856-2116 2015-10-16
1295152205 Evelyn Huang Family Medicine 1000 Medical Center Dr, Monticello, IL 61856-2116 2014-03-27
1659713139 David C Liss Nurse Practitioner 1000 Medical Center Dr, Monticello, IL 61856-2116 2013-07-24
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1538565783 Jeffrey D. Hanley Hearing Instrument Specialist 107 S. State Street, Audibel Hearing Aids, Monticello, IL 61856 2014-11-17
1073636510 John Paul Rupkey Pharmacist 1212 Bear Lane, Monticello, IL 61856 2007-04-09
1104959998 Pediatric Physical Therapy of Central Illinois Ltd Physical Therapist 123 W William Street, Monticello, IL 61856 2007-03-13
1184774820 Curtis E Johnson Optometrist 102 S Charter, Monticello, IL 61856 2007-01-12
1639186315 Bruce Charles Wintersteen Dentist 112 E Wash St, Monticello, IL 61856 2006-08-02
1043251846 Lauren A Coovert Physician Assistant 1000 Medical Center Drive, Monticello, IL 61856 2006-06-10
1295814556 Piatt Co Skilled Nursing Facility 1111 N State St, Monticello, IL 61856 2006-11-06
1952325417 Brandon J Hissong Dentist 806 W Bridge St, Monticello, IL 61856-1038 2006-07-27
1124019286 Laura Patricia Lee Physician Assistant 1111 N State St, Monticello, IL 61856-1151 2005-10-28
1376524322 Kirby Medical Center Durable Medical Equipment & Medical Supplies 1111 N State St, Monticello, IL 61856-1151 2005-11-08
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912508722 Tlc Healthcare LLC Nurse Practitioner 202 N Main St Ste A, Monticello, IA 52310-1746 2020-11-06
1194232207 Jacob Dudley Coffey Nurse Practitioner 1 S Creek Dr Ste 102606, Monticello, KY 42633 2018-01-10
1992215354 Derek Lee White Nurse Practitioner 385 Old Troy Rd, Monticello, AR 71655-9181 2017-10-11
1720160526 Cumberland Gastroenterology, P.s.c. Nurse Practitioner 1 Southcreek Drive, Monticello, KY 42633 2006-10-20
1659363612 Shirley L Van Horn Nurse Practitioner 17 Hamilton Ave., Monticello, NY 12701 2005-08-16
1578560405 Carol Marguerite Brinkman Nurse Practitioner 9766 Fallon Ave Ne Ste 102, Monticello, MN 55362-4589 2005-07-07
1841838794 Brandy Jackson Nurse Practitioner 895 N Main St, Monticello, KY 42633-1580 2019-12-11
1487290961 Hannah A Hilton Nurse Practitioner 535 Jordan Dr, Monticello, AR 71655-5714 2019-11-20
1437621612 David Christopher Morgan Nurse Practitioner 38 Concord Rd, Monticello, NY 12701-3210 2018-12-27
1730667759 Ginger Conn Nurse Practitioner 895 N Main St, Monticello, KY 42633-1580 2018-08-01
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Competitor

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City MONTICELLO
Zip Code 61856

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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