KRISTINA ANNE CLARK
NPI 1912848656
Internal Medicine in Maywood, IL

Q: What is Kristina Clark's NPI number?

The NPI number for Kristina Clark is 1912848656. It was assigned to this individual provider in the NPPES registry on April 6, 2026.

Q: What is Kristina Clark's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Kristina Clark was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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 April 06, 2026PECOS Enrolled

2160 S 1ST AVE, MAYWOOD, IL 60153(888) 584-7888 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 18, 2026, Apr 6, 2026 (2 updates tracked since 2026).

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About Kristina Anne Clark NPPES

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

KRISTINA ANNE CLARK (NPI 1912848656) is an individual internal medicine provider in Maywood, Illinois, licensed in Illinois (125.087741) and active in the NPI registry since April 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912848656

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameKRISTINA ANNE CLARK

Location Address2160 S 1ST AVEMaywood, IL 60153-3328

Mailing Address2160 S 1st AveMaywood, IL 60153-3328 · (708) 717-6709

Phone(888) 584-7888

Sole ProprietorNo

Enumeration DateApril 6, 2026

Last NPPES UpdateMay 18, 20262 updates tracked since enumeration

NPPES CertifiedMay 18, 2026

✔ NPI 1912848656 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 125.087741

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2160 S 1ST AVE, Maywood, IL 60153

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kristina Anne Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60153 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$138.86 typical visit price

range $60.08 – $183.39

Typical copayment $34.71 (range $15.02 – $45.84)

Most-billed visit code 99204

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

ANITA OZA NAGAMINE M.D.

Radiology (Diagnostic Radiology)