Provider Demographics
NPI:1083891477
Name:CLARK, CAMERON DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:DAVID
Last Name:CLARK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W HIGGINS RD STE 310
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-7214
Mailing Address - Country:US
Mailing Address - Phone:478-398-8888
Mailing Address - Fax:847-839-9660
Practice Address - Street 1:2500 W HIGGINS RD STE 310
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-7214
Practice Address - Country:US
Practice Address - Phone:478-398-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-011121111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor