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DR. JENNIFER M. CLARK D.C.
NPI 1144389024
Chiropractor in Peoria, IL

Active since December 07, 2006
4900 N GLEN PARK PLACE RD, SUITE B, PEORIA, IL 61614(309) 645-9665 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Jennifer M. Clark D.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JENNIFER M. CLARK D.C. (NPI 1144389024) is an individual chiropractor in Peoria, Illinois and active in the NPI registry since December 2006. She is a graduate of Other (2005).

NPPES Registry Identity

NPI1144389024
Entity TypeIndividualFemale
Primary Taxonomy111N00000X
Provider Legal NameDR. JENNIFER M. CLARKCredential: D.C.
Location Address4900 N GLEN PARK PLACE RD, SUITE BPeoria, IL 61614-4679
Mailing Address1006 W Centennial DrPeoria, IL 61614-2828 · (309) 692-9228
Phone(309) 645-9665
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateDecember 7, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1144389024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

4900 N GLEN PARK PLACE RD, Peoria, IL 61614
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jennifer M. Clark D.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5597869875
PECOS Enrollment IDI20070326000401

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FITCH ENTERPRISES OF PEORIA, LLC
Optometrist (Vision Therapy)
4900 N GLEN PARK PLACE RD, SUITE C2
PEORIA, IL 61614
Peoria County (309) 691-4500
RONALD J SUAREZ O.D.
Optometrist
4900 N GLEN PARK PLACE RD, SUITE C
PEORIA, IL 61614
Peoria County (309) 691-4500
ROGER W FITCH OD
Optometrist
4900 N GLEN PARK PLACE RD, SUITE C
PEORIA, IL 61614
Peoria County (309) 691-4500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer Clark's NPI number?

The NPI number for Jennifer Clark is 1144389024. It was assigned to this individual provider in the NPPES registry on December 7, 2006.

Where is Jennifer Clark located?

Jennifer Clark practices at 4900 N Glen Park Place Rd Suite B, Peoria, IL 61614. The listed phone number is (309) 645-9665.

What is Jennifer Clark's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Jennifer Clark enrolled in Medicare?

Yes. Jennifer Clark is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jennifer Clark was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.