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

Mr. Theodore R Clark III

Individual provider Diagnostic Radiology Physician · NPI 1568233260

Mr. Theodore R Clark III is a Diagnostic Radiology Physician in North Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2024

Practice location Address checks out

3001 Green Bay Rd
North Chicago, IL 60064-3048
Phone: (847) 688-1900
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 533773 (IL)

Record details

NPI number1568233260
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 11, 2024
Last updated in NPPESJanuary 11, 2024
Certification dateJanuary 11, 2024

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