MS. KELLY DAWN CLARK RPH
NPI 1780703520
Pharmacist in Champaign, IL

Active since March 29, 2007
1802 S MATTIS AVE, CHAMPAIGN, IL 61821(217) 326-1399 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Kelly Dawn Clark Rph NPPES

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

MS. KELLY DAWN CLARK RPH (NPI 1780703520) is an individual pharmacist in Champaign, Illinois and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1780703520
Entity TypeIndividualFemale
Primary Taxonomy183500000X
Provider Legal NameMS. KELLY DAWN CLARKCredential: RPH
Location Address1802 S MATTIS AVEChampaign, IL 61821-5923
Mailing Address3405 Country Bend PlChampaign, IL 61822-6155 · (217) 355-9363
Sole ProprietorNo
Enumeration DateMarch 29, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1780703520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
1802 S MATTIS AVE, Champaign, IL 61821

Other Providers at the Same Location NPPES 20

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

Psychologist
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Durable Medical Equipment & Medical Supplies
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Physical Medicine & Rehabilitation
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Physician Assistant (Surgical)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Psychologist
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Social Worker (Clinical)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Social Worker (Clinical)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Nurse Practitioner (Psychiatric/Mental Health)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821

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 Kelly Clark's NPI number?

The NPI number for Kelly Clark is 1780703520. It was assigned to this individual provider in the NPPES registry on March 29, 2007.

Where is Kelly Clark located?

Kelly Clark practices at 1802 S Mattis Ave, Champaign, IL 61821. The listed phone number is (217) 326-1399.

What is Kelly Clark's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Kelly Clark was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.