| Mr Theodore R Clark Iii, | |
|
3001 Green Bay Rd, North Chicago, IL 60064-3048 | |
| (847) 688-1900 | |
| Not Available |
| Full Name | Mr Theodore R Clark Iii |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 3001 Green Bay Rd, North Chicago, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568233260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 533773 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Theodore R Clark Iii, 17597 W Horseshoe Ln, Gurnee, IL 60031-4231 Ph: (919) 634-1902 | Mr Theodore R Clark Iii, 3001 Green Bay Rd, North Chicago, IL 60064-3048 Ph: (847) 688-1900 |
Vaishali S Lafita, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3001 Green Bay Rd Dept 1332d103, North Chicago, IL 60064 Phone: 224-610-1536 | |
Dr. Rebecca Jones Rohrer, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 3001 Green Bay Rd, North Chicago, IL 60064 Phone: 224-610-1197 | |
Piyush I Vyas, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3001 Green Bay Rd, North Chicago, IL 60064 Phone: 847-688-1900 | |
Ofelia Lima, Radiology Medicare: Not Enrolled in Medicare Practice Location: 3001 Green Bay Rd, North Chicago, IL 60064 Phone: 224-610-4356 | |
Ryan W Lutz, Radiology Medicare: Medicare Enrolled Practice Location: 3001 Green Bay Rd, North Chicago, IL 60064 Phone: 224-610-3886 |