| Doctor Name: | MR. MICHAEL J CLARKE |
| NPI Number: | 1912064569 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA-CCC. SLP |
| License Number: | 34-154 |
| Business Practice Address: | 1412 Landon Ave Winthrop Harbor, IL - 600961844 |
| Business Phone Number: | 8473615530 |
| Business Fax Number: | 8478724817 |
| Mailing Address: | 1412 Landon Ave, WINTHROP HARBOR |
| State: | IL |
| Postal Code: | 600961844 |
| Phone Number: | 8473615530 |
| Fax Number: | 8478724817 |
| NPI Enumeration Date: | 01/02/2007 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 34-154 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |