Provider Demographics
NPI:1003834375
Name:CLARK-ROBERTS, AKESHA CHEMEIN (CNA)
Entity Type:Individual
Prefix:MRS
First Name:AKESHA
Middle Name:CHEMEIN
Last Name:CLARK-ROBERTS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 S NELSON AVE
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-5619
Mailing Address - Country:US
Mailing Address - Phone:815-304-5418
Mailing Address - Fax:
Practice Address - Street 1:641 S NELSON AVE
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-5619
Practice Address - Country:US
Practice Address - Phone:815-304-5418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide