Kilmeny Clark, - Medicare Physician Assistant in Carbondale, IL

Kilmeny Clark, is a medicare enrolled "Physician Assistant" in Carbondale, Illinois. Her current practice location is 300 W Oak St, Carbondale, Illinois. You can reach out to her office (for appointments etc.) via phone at (618) 453-8850.

Kilmeny Clark is licensed to practice in Wisconsin (license number 5318-23) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104443258.

Contact Information

Kilmeny Clark,
300 W Oak St,
Carbondale, IL 62901-1400
(618) 453-8850
Not Available



Provider's Profile

Full NameKilmeny Clark
GenderFemale
SpecialityPhysician Assistant
Location300 W Oak St, Carbondale, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1104443258
  • Provider Enumeration Date: 07/05/2020
  • Last Update Date: 12/31/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 3971912155
  • Enrollment ID: I20210430000042

Medical Identifiers

Medical identifiers for Kilmeny Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104443258NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 085.008097 (Illinois)Secondary
363A00000XPhysician Assistant 5318-23 (Wisconsin)Primary

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. Kilmeny 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
Kilmeny Clark,
1800 E Lake Shore Dr,
Decatur, IL 62521-3810

Ph: (217) 464-2973
Kilmeny Clark,
300 W Oak St,
Carbondale, IL 62901-1400

Ph: (618) 453-8850

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› Verified 4 days ago


Physician Assistant Nurses in Carbondale, IL

Mr. Lukas Ward, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 405 W Jackson St, Carbondale, IL 62901
Phone: 618-549-0721    Fax: 618-529-0479
Ms. Britney Nicole Arnold, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 405 W Jackson St, Carbondale, IL 62901
Phone: 618-549-0721    Fax: 618-457-0469
Joeli Diemer, PAC
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 300 W Oak St, Carbondale, IL 62901
Phone: 618-536-6621    
Ms. Nicole A Johnson, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 405 W Jackson St, Carbondale, IL 62901
Phone: 618-549-0721    
Mr. Michael Leroy Matteson, PA C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 305 W Jackson St, Suite 105, Carbondale, IL 62901
Phone: 618-536-2565    Fax: 618-536-2835
John Howard Davidson, PA
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 405 W Jackson St, Carbondale, IL 62901
Phone: 618-549-0721    Fax: 618-457-0469

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