KENDRA CLARK (NPI# 1831661958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831661958 |
| Entity Type | Individual |
| Full Name | KENDRA CLARK |
| Practice Address |
455 E Main St East Dundee IL 60118-1529 |
| Mailing Address |
7 Hills Healthcare Center 455 E Main St. East Dundee IL 60118 |
| Practice Telephone | 8474282273 |
| Mailing Telephone | 8474282273 |
| Enumeration Date | 2018-12-31 |
| Last Update Date | 2018-12-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 171M00000X | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 455 E Main St, East Dundee, IL 601181529 | 8474282273 | |
| 7 Hills Healthcare Center, 455 E Main St, East Dundee, IL 60118 | 8474282273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821284787 | Kendra Marie Clark | Physician Assistant | 7782 E Fledgling Dr, Scottsdale, AZ 85255-7716 | 2007-09-24 |
| 1831738087 | Kendra Nicole Clark | Dentist | 3880 Hulen St Ste 310, Fort Worth, TX 76107-7274 | 2020-01-04 |
| 1942590005 | Kendra E. Clark | Case Manager/Care Coordinator | 2600 E 18th St, Cheyenne, WY 82001-5511 | 2011-04-11 |
| 1457491870 | Kendra M Clark | Dietitian, Registered | 501 S Union Ave, Food and Nutrition Department, Havre De Grace, MD 21078-3409 | 2007-02-07 |
| Street Address |
455 E MAIN ST |
| City | EAST DUNDEE |
| State | IL |
| Zip Code | 60118-1529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346294469 | Srinivas R Ravanam | Internal Medicine | 455 E Main St, East Dundee, IL 60118-1529 | 2006-05-22 |
| 1427657634 | Ashley Ann Gregg | Nurse Practitioner | 455 E Main St, East Dundee, IL 60118-1529 | 2020-10-19 |
| 1225674914 | Quinette Iheanyichukwu | Nurse Practitioner | 455 E Main St, East Dundee, IL 60118-1529 | 2019-11-18 |
| 1891336020 | Adelwisa C Ave | Nurse Practitioner | 455 E Main St, East Dundee, IL 60118-1529 | 2019-09-29 |
| 1619539228 | Aieden G Padao | Nurse Practitioner | 455 E Main St, East Dundee, IL 60118-1529 | 2019-07-03 |
| 1497227516 | Hiral Rawal | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-31 |
| 1912479031 | Samantha Wright-atkins | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-31 |
| 1285106245 | Lashanda Maxwell | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-31 |
| 1831661891 | Luis Hernandez | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-31 |
| 1023580164 | Kinjal Bhatt | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093291411 | Pro Dental Care Ltd | Clinic/Center | 1053 Main Street, Sleepy Hollow, IL 60118 | 2018-07-18 |
| 1104333640 | Natasha Ann Radnovich | Behavioral Analyst | 533 S 5th St, West Dundee, IL 60118 | 2018-01-05 |
| 1588105639 | Rabije Hajdini | Counselor | 528 Market Loop # 4b, West Dundee, IL 60118 | 2017-03-08 |
| 1942752548 | Suhark Healthcare and Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 600 Spring Hill Ring Rd Ste 109, West Dundee, IL 60118 | 2016-10-29 |
| 1386043867 | Jennifer Pate | Physical Therapist | 117 S 6th St, West Dundee, IL 60118 | 2014-08-20 |
| 1255755096 | Associates In Behavioral Health Care | Counselor | 783 8th Street, Century Plaza, West Dundee, IL 60118 | 2014-02-14 |
| 1003043290 | Castle Ventures, Inc. | In Home Supportive Care | 513 W. Main St., W. Dundee, IL 60118 | 2009-06-16 |
| 1114199965 | Brian Scott Vence | Dentist | 700 Willow Lane, Suite G, West Dundee, IL 60118 | 2008-04-01 |
| 1871703595 | Pallavi Gangupantula | Physical Therapist | 600 Spring Hill Ring Road,suite 118, West Dundee, IL 60118 | 2007-05-23 |
| 1104965219 | Barbra Mccoy Getz | Social Worker | 213 Jamestowne, Sleepy Hollow, IL 60118 | 2007-02-05 |
| Find all providers in zip 60118 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497227516 | Hiral Rawal | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-31 |
| 1912479031 | Samantha Wright-atkins | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-31 |
| 1285106245 | Lashanda Maxwell | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-31 |
| 1831661891 | Luis Hernandez | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-31 |
| 1023580164 | Kinjal Bhatt | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-31 |
| 1225500457 | Kayla Camp | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-28 |
| 1477025625 | Lindsay Dort | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-28 |
| 1124590328 | Kanahi Beathea | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-28 |
| 1073085262 | Teresa C Pierce | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-28 |
| 1306318654 | Alexis Kaul | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-27 |
| Find all providers in EAST DUNDEE | ||||
| City | EAST DUNDEE |
| Zip Code | 60118 |
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| 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.