Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kasandria Clark, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1801538251

Dr. Kasandria Clark, MD is a Pediatric Medicine in Chicago, Illinois. Qualified in 2022, 4 years ago. Works from 2 locations. Licensed in Illinois.

Years since qualifying
4
Licensed in
IL
In the registry since
2022
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1555 W Howard St
Chicago, IL 60626-1707
Phone: (773) 764-7146
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1675 Dempster St, Park Ridge, IL 60068-1110 — (847) 318-9300

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 036172412 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1801538251
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 7, 2022
Last updated in NPPESJune 9, 2025
Certification dateJune 9, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated

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