STEPHEN J. CLARK M.D.,P.C.
NPI 1487772208
Clinic/Center - Primary Care in Lindenhurst, IL
About Stephen J. Clark M.d.,p.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STEPHEN J. CLARK M.D.,P.C. (NPI 1487772208) is a healthcare organization registered as a primary care in Lindenhurst, Illinois and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through January 4, 2027 and lists Stephen J. Clark, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Stephen J. Clark M.d.,p.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Stephen J. Clark M.D.,p.C., which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Lindenhurst, IL 60046
Lindenhurst, IL 60046
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 14D1093858
Stephen J Clark MD PC · Lindenhurst, ILFrequently 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 Stephen J. Clark M.D.,p.C.'s NPI number?
The NPI number for Stephen J. Clark M.D.,p.C. is 1487772208. It was assigned to this organization in the NPPES registry on March 27, 2007.
Where is Stephen J. Clark M.D.,p.C. located?
Stephen J. Clark M.D.,p.C. is located at 3021 Falling Waters Blvd Suite A, Lindenhurst, IL 60046. The listed phone number is (847) 356-9300.
What is Stephen J. Clark M.D.,p.C.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Stephen J. Clark M.D.,p.C. enrolled in Medicare?
Yes. Stephen J. Clark M.D.,p.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Stephen J. Clark M.D.,p.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Stephen J. Clark M.D.,p.C., in Family Practice and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Stephen J. Clark M.D.,p.C. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 14D1093858) is associated with this NPI, valid through January 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Stephen J. Clark M.D.,p.C. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Stephen J. Clark M.d.,p.c. · NPI 1487772208
Primary Care organization in Lindenhurst, Illinois. Organization record, active in the CMS NPPES registry since March 27, 2007.
## Identity
- **NPI:** 1487772208 (Entity type: Organization)
- **Enumerated:** March 27, 2007
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Stephen Clark, PRESIDENT
## Practice location
- **Address:** 3021 FALLING WATERS BLVD, SUITE A, Lindenhurst, IL 60046-6793
- **Phone:** (847) 356-9300 · **Fax:** (847) 356-7260
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (2), Internal Medicine (1); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1487772208) · Data from the CMS NPPES public registry.