{"npi":"1073504767","type":"NPI-1","status":"active","name":{"display":"Todd Clark Medical Doctor","other":[],"first":"TODD","last":"CLARK","credential":"MEDICAL DOCTOR"},"specialty":{"primary_taxonomy":"207P00000X","primary_taxonomy_description":"Emergency Medicine","slug":"emergency-medicine","schema_org_specialty":"Emergency","all":[{"code":"207P00000X","description":"Emergency Medicine","primary":false,"state":"CA","license":"A84896"},{"code":"207PE0004X","description":"Emergency Medical Services (Emergency Medicine) Physician","primary":false,"state":"CA","license":"A84896"},{"code":"207PE0004X","description":"Emergency Medical Services (Emergency Medicine) Physician","primary":false,"state":"IL","license":"036-107180"},{"code":"207P00000X","description":"Emergency Medicine","primary":true,"state":"IL","license":"036-107180"}]},"addresses":[{"purpose":"LOCATION","street_1":"1775 W DEMPSTER ST","city":"PARK RIDGE","state":"IL","postal_code":"600681143","country_code":"US","street_2":"1 WEST","phone":"8477235150","fax":"8477232083"},{"purpose":"MAILING","street_1":"29373 NETWORK PL","city":"CHICAGO","state":"IL","postal_code":"606731143","country_code":"US","phone":"8473905900"}],"license":{"state":"IL","number":"036-107180"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"00A84896","state":"CA","issuer":null},{"type_code":"05","label":"Medicaid","value":"00A848960","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20091021000159","type_code":"14-93","type_desc":"PRACTITIONER - EMERGENCY MEDICINE","state":"IL","pac_id":"1658278452"}]},"enumeration_date":"2005-11-02","last_updated":"2022-09-19","_meta":{"source":"NPPES","snapshot_date":"2022-09-19","doc_url":"https://findmynpi.com/api"}}