Jillian Miranda Clark, RN is a
Registered Nurse - Emergency based in Mahomet, Illinois. Jillian Miranda Clark is licensed to practice in Illinois (license number 041602351) and her current practice location is
291 Du Page St, Mahomet, Illinois. She can be reached at her office (for appointments etc.) via phone at
(224) 284-3268.
NPI number for Jillian Miranda Clark is 1730033127 and her current mailing address is 291 Du Page St, Mahomet, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1730033127.
Provider's Profile
| Full Name | Jillian Miranda Clark |
|---|
| Gender | Female |
|---|
| Speciality | Registered Nurse - Emergency |
|---|
| Location | 291 Du Page St, Mahomet, Illinois |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1730033127
- Provider Enumeration Date: 02/24/2026
- Last Update Date: 02/24/2026
Medical Identifiers
Medical identifiers for Jillian Miranda Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1730033127 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 163WE0003X | Registered Nurse - Emergency | 041602351 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jillian Miranda Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Jillian Miranda Clark, RN 291 Du Page St, Mahomet, IL 61853-9414 Ph: Not Available | Jillian Miranda Clark, RN 291 Du Page St, Mahomet, IL 61853-9414 Ph: (224) 284-3268 |
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