CLARK CHIROPRACTIC CENTER, LLC
NPI 1215090337
Chiropractor in Peoria, IL
About Clark Chiropractic Center, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLARK CHIROPRACTIC CENTER, LLC (NPI 1215090337) is a healthcare organization registered as a chiropractor in Peoria, Illinois and active in the NPI registry since December 2006. The organization lists Jennifer M. Clark, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Clark Chiropractic Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Clark Chiropractic Center, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Clark Chiropractic Center, LLC's NPI number?
The NPI number for Clark Chiropractic Center, LLC is 1215090337. It was assigned to this organization in the NPPES registry on December 19, 2006.
Where is Clark Chiropractic Center, LLC located?
Clark Chiropractic Center, LLC is located at 4900 N Glen Park Place Rd Ste B, Peoria, IL 61614. The listed phone number is (309) 645-9665.
What is Clark Chiropractic Center, LLC's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Clark Chiropractic Center, LLC enrolled in Medicare?
Yes. Clark Chiropractic Center, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Clark Chiropractic Center, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Clark Chiropractic Center, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Clark Chiropractic Center, LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.
# Clark Chiropractic Center, Llc · NPI 1215090337
Chiropractor organization in Peoria, Illinois. Organization record, active in the CMS NPPES registry since December 19, 2006.
## Identity
- **NPI:** 1215090337 (Entity type: Organization)
- **Enumerated:** December 19, 2006
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** Jennifer Clark, OWNER
## Practice location
- **Address:** 4900 N GLEN PARK PLACE RD STE B, Peoria, IL 61614-4685
- **Phone:** (309) 645-9665
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1215090337) · Data from the CMS NPPES public registry.