IndividualActive
Kelly Clark, RPH
NPI 1780703520 · Pharmacist · Champaign, IL
Provider details
- NPI number
- 1780703520
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Credential
- RPH
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Pharmacy Service Providers
Practice location
1802 S Mattis Ave
Champaign, IL 61821-5923
Phone: (217) 326-1399
Approximate (ZIP-level) locationGet directions
Mailing address
3405 Country Bend Pl
Champaign, IL 61822-6155
Registry dates
- Enumerated
- 2007-03-29
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.