Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SUE CLARK MD
NPI 1174597371
Pediatrics - Developmental - Behavioral Pediatrics in Peoria, IL

Q: What is Sue Clark's NPI number?

The NPI number for Sue Clark is 1174597371. It was assigned to this individual provider in the NPPES registry on February 14, 2006.

Q: What is Sue Clark's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

Q: When was this NPI record last updated?

The NPPES record for Sue Clark was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 14, 2006PECOS Enrolled

507 E ARMSTRONG AVE, REGIONAL DEVELOPMENT CENTER, PEORIA, IL 61603(309) 681-6960 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Sue Clark Md NPPES

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

SUE CLARK MD (NPI 1174597371) is an individual developmental - behavioral pediatrics provider in Peoria, Illinois and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174597371

Entity TypeIndividualFemale

Primary Taxonomy2080P0006X

Provider Legal NameSUE CLARKCredential: MD

Location Address507 E ARMSTRONG AVE, REGIONAL DEVELOPMENT CENTERPeoria, IL 61603-3201

Mailing Address1 Illini DrPeoria, IL 61605-2576 · (309) 671-8503

Phone(309) 681-6960

Sole ProprietorNo

Enumeration DateFebruary 14, 2006

Last NPPES UpdateJuly 13, 2026

✔ NPI 1174597371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Developmental - Behavioral PediatricsAllopathic & Osteopathic Physicians

Taxonomy Code2080P0006X

Definition

A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.

507 E ARMSTRONG AVE, Peoria, IL 61603

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Other Identifiers 2

Other07215036IL · Bcbs

OtherIL01Z4IL · John Deere

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sue Clark Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

MR. KRISTIN M FAULKNER

Speech-Language Pathologist