Kilmeny Clark
Physician Assistant in Bloomington, IL. Individual provider (NPI-1).
NPI number1104443258
StatusActive
Last updated in NPPESJun 9, 2025
Details
- NPI
- 1104443258
- Entity type
- Individual (NPI-1)
- Name
- Kilmeny Clark
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 5, 2020
- Certification date
- May 21, 2025
- Last updated
- Jun 9, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085.008097 | IL | Yes |
| 363A00000X | Physician Assistant | 5318-23 | WI |
Practice location
3024 E Empire StBloomington, IL 61704-5402
Phone 309-556-7556 · Fax 309-556-7551
Mailing address
611 W Park StFapc
Urbana, IL 61801-2500
Other practice locations
300 W Oak St
Carbondale, IL 62901-1400
Carbondale, IL 62901-1400
Phone 618-453-8850
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physician Assistant providers in Bloomington, IL
- Renee Alwan Percell, P.A.-C.NPI 1588653935
- Cynthia Anagnos, PA-CNPI 1558500579
- Hannah Bethany Atkins, PA-CNPI 1922619535
- Nicholas David Bartelsmeyer, PA-CNPI 1639084346
- Melody Ann Bauman, PA-CNPI 1487172409
- Megan BeckerNPI 1073183844
- Danielle BeerNPI 1114271905
- Braden James Carius, PANPI 1326618802
- Astha Chokshi, PANPI 1710797469
- Compass Counselors Ltd.NPI 1225912231
All 40 Physician Assistant providers in Bloomington · All 2,449 providers in Bloomington
Checking a whole list?
Paste a list of NPIs and get status, record, Medicare enrollment and OIG exclusion for each one. 100 free a day, then from $5 for 5,000. Useful for credentialing, billing and pharmacy claim checks.