| Jacob Clark, | |
|
530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | |
| (309) 655-2000 | |
| Not Available |
| Full Name | Jacob Clark |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Medical |
| Location | 530 Ne Glen Oak Ave, Peoria, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013614304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Clark, 4537 Tundra Ln, Mcfarland, WI 53558-9158 Ph: (605) 521-8056 | Jacob Clark, 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 Ph: (309) 655-2000 |
Ms. Courtney M Jaegle, PA Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 112 Ne Crescent Ave, Peoria, IL 61606 Phone: 309-672-4670 Fax: 309-672-4669 | |
Natalie Patty, Physician Assistant Medicare: Medicare Enrolled Practice Location: 5111 N Glen Park Place Rd, Peoria, IL 61614 Phone: 309-683-5700 | |
Rob Wimmer, P.A. Physician Assistant Medicare: Medicare Enrolled Practice Location: 7309 N Knoxville Ave, Peoria, IL 61614 Phone: 309-692-9898 | |
Benjamin Richard Tellier, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 723 Ne Glen Oak Ave, Peoria, IL 61603 Phone: 309-624-8749 Fax: 309-624-8870 | |
Abigail Rose Sutton, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 303 N William Kumpf Blvd, Peoria, IL 61605 Phone: 309-676-5546 Fax: 309-676-5045 | |
Richard S Seaboch, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5405 N Knoxville Ave, Peoria, IL 61614 Phone: 309-691-4410 Fax: 309-589-2830 |