MR. JOHN RILEY CLARK PA-C
NPI 1063072973
Physician Assistant - Medical in Oswego, IL

Q: What is John Clark's NPI number?

The NPI number for John Clark is 1063072973. It was assigned to this individual provider in the NPPES registry on June 13, 2019.

Q: What is John Clark's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for John Clark was last updated on August 2, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 13, 2019

2700 LIGHT RD APT 102, OSWEGO, IL 60543(415) 516-8668 Get Directions Write a Review

NPPES record last updated: August 2, 2019. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 2, 2019, Jun 13, 2019 (2 updates tracked since 2019).

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About Mr. John Riley Clark Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JOHN RILEY CLARK PA-C (NPI 1063072973) is an individual medical provider in Oswego, Illinois, licensed in Illinois (085.007136) and active in the NPI registry since June 2019.

NPPES Registry Identity

NPI1063072973

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. JOHN RILEY CLARKCredential: PA-C

Location Address2700 LIGHT RD APT 102Oswego, IL 60543-9231

Mailing Address2700 Light Rd Apt 102Oswego, IL 60543-9231 · (415) 516-8668

Phone(415) 516-8668

Sole ProprietorYes

Enumeration DateJune 13, 2019

Last NPPES UpdateAugust 2, 20192 updates tracked since enumeration

✔ NPI 1063072973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in IL · 085.007136

2700 LIGHT RD APT 102, Oswego, IL 60543

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Clark's NPI number?

The NPI number for John Clark is 1063072973. It was assigned to this individual provider in the NPPES registry on June 13, 2019.

Where is John Clark located?

John Clark practices at 2700 Light Rd Apt 102, Oswego, IL 60543. The listed phone number is (415) 516-8668.

What is John Clark's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for John Clark was last updated on August 2, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.