MACIE M CLARK LPN
NPI 1497238612
Licensed Practical Nurse in Du Quoin, IL

Q: What is Macie Clark's NPI number?

The NPI number for Macie Clark is 1497238612. It was assigned to this individual provider in the NPPES registry on September 13, 2018.

Q: What is Macie Clark's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Macie Clark was last updated on September 13, 2018. 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 September 13, 2018

1564 S WASHINGTON ST, DU QUOIN, IL 62832(618) 542-8702 Get Directions Write a Review

NPPES record last updated: September 13, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Macie M Clark Lpn NPPES

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

MACIE M CLARK LPN (NPI 1497238612) is an individual licensed practical nurse in Du Quoin, Illinois, licensed in Illinois (043125988) and active in the NPI registry since September 2018.

NPPES Registry Identity

NPI1497238612

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameMACIE M CLARKCredential: LPN

Location Address1564 S WASHINGTON STDu Quoin, IL 62832-3849

Mailing Address4241 Highway 14 WChristopher, IL 62822-1037

Phone(618) 542-8702

Sole ProprietorNo

Enumeration DateSeptember 13, 2018

✔ NPI 1497238612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in IL · 043125988

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

1564 S WASHINGTON ST, Du Quoin, IL 62832

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Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANALIESE WILMSMEYER PA-S

Physician Assistant