Nathaniel Clark, PA - Medicare Physician Assistant in Carbondale, IL

Nathaniel Clark, PA is a medicare enrolled "Physician Assistant" physician in Carbondale, Illinois. He graduated from medical school in 2008 and has 16 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Deaconess Illinois Specialty Clinic, Inc. and his current practice location is 409 W Oak St, Carbondale, Illinois. You can reach out to his office (for appointments etc.) via phone at (618) 529-4455.

Nathaniel Clark is licensed to practice in Illinois (license number 085003278) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1063660074.

Contact Information

Nathaniel Clark, PA
409 W Oak St,
Carbondale, IL 62901-1464
(618) 529-4455
(618) 351-1287



Physician's Profile

Full NameNathaniel Clark
GenderMale
SpecialityPhysician Assistant
Experience16 Years
Location409 W Oak St, Carbondale, Illinois
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Nathaniel Clark graduated from medical school in 2008
  NPI Data:
  • NPI Number: 1063660074
  • Provider Enumeration Date: 09/03/2008
  • Last Update Date: 12/21/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 7315015948
  • Enrollment ID: I20081008000708

Medical Identifiers

Medical identifiers for Nathaniel Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063660074NPI-NPPES
P00657126OtherILRAILROAD MEDICARE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RI0011XInternal Medicine - Interventional Cardiology 085-003278 (Illinois)Secondary
363A00000XPhysician Assistant 085003278 (Illinois)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Heartland Regional Medical CenterMarion, ILHospital
Southern Illinois Hospital Services Dba Herrin HospitalHerrin, ILHospital
St Louis University HospitalSaint louis, MOHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Deaconess Illinois Specialty Clinic, Inc.983056201681

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nathaniel Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Nathaniel Clark, PA
409 W Oak St,
Carbondale, IL 62901-1464

Ph: (618) 529-4555
Nathaniel Clark, PA
409 W Oak St,
Carbondale, IL 62901-1464

Ph: (618) 529-4455

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