Jerome Clark

NPI #1013465145 in Waukegan, Illinois

Provider Information

NPI Number: 1013465145
Entity Type: Individual
Name: Jerome Clark
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Enumeration Date: Sep 19, 2016
Last Updated: Sep 19, 2016

Practice Location

Address: 671 S LEWIS AVE
City: Waukegan
State: Illinois
ZIP Code: 60085-6101
Phone: (847) 782-4000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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