| Donald Lee Clark Iii, FNP-BC | |
|
2100 Madison Ave, Granite City, IL 62040-4713 | |
| (618) 798-3000 | |
| Not Available |
| Full Name | Donald Lee Clark Iii |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 2100 Madison Ave, Granite City, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366090573 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 209019719 (Illinois) | Primary |
| Entity Name | Marshall Browning Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821099441 PECOS PAC ID: 9335049980 Enrollment ID: O20040226000868 |
| Entity Name | Morrison Community Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700907250 PECOS PAC ID: 2466349907 Enrollment ID: O20040301000685 |
| Entity Name | Hamilton Memorial Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609837665 PECOS PAC ID: 6608865985 Enrollment ID: O20040511001018 |
| Entity Name | Morrison Community Hospital District |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1184844938 PECOS PAC ID: 2466349907 Enrollment ID: O20080716000761 |
| Entity Name | Granite City Hospitalist Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669926424 PECOS PAC ID: 8527356591 Enrollment ID: O20161006000282 |
| Entity Name | Emergency Services Midwest Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174024806 PECOS PAC ID: 2769746056 Enrollment ID: O20180515000619 |
| Entity Name | Statera Health Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043874449 PECOS PAC ID: 0244565729 Enrollment ID: O20190708000284 |
| Entity Name | Trinity Medical Staffing Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770103426 PECOS PAC ID: 1759712698 Enrollment ID: O20200511000598 |
| Entity Name | Deaconess Illinois Specialty Clinic, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972210235 PECOS PAC ID: 9830562016 Enrollment ID: O20230321001688 |
| Entity Name | Ahs Il Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659098101 PECOS PAC ID: 5496111676 Enrollment ID: O20230512001300 |
| Mailing Address | Practice Location Address |
|---|---|
| Donald Lee Clark Iii, FNP-BC 8308 Burlington Dr, Troy, IL 62294-4003 Ph: (618) 402-3946 | Donald Lee Clark Iii, FNP-BC 2100 Madison Ave, Granite City, IL 62040-4713 Ph: (618) 798-3000 |
Kierstin Hancock, PMHNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 54 Northgate Industrial Dr, Granite City, IL 62040 Phone: 618-877-4420 | |
Stephanie King, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3732 Nameoki Rd, Granite City, IL 62040 Phone: 314-687-2735 | |
Dalton Alexander Halm, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2100 Madison Ave, Granite City, IL 62040 Phone: 619-798-3000 | |
Diane M Schwind, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2044 Madison Ave, Suite 15, Granite City, IL 62040 Phone: 618-451-1500 | |
Dr. Jaime Ann Campbell, DNP, PMHNP-BC Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 50 Northgate Industrial Dr, Granite City, IL 62040 Phone: 618-512-1919 Fax: 618-512-1920 | |
Julienne Carol Szlufik, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 50 Northgate Industrial Dr, Granite City, IL 62040 Phone: 618-877-4420 | |
Robyn Wendt, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 50 Northgate Industrial Dr, Granite City, IL 62040 Phone: 618-877-4420 |