DICKERSON CHIROPRACTIC AND WELLNESS CENTER PC
NPI 1396944559
Chiropractor in East Peoria, IL

Q: What is Dickerson Chiropractic And Wellness Center PC's specialty?

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

Active since July 17, 2007

100 N MAIN ST, SUITE 101, EAST PEORIA, IL 61611(309) 699-7900 Get Directions Write a Review

NPPES record last updated: August 6, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Dickerson Chiropractic And Wellness Center Pc NPPES

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

DICKERSON CHIROPRACTIC AND WELLNESS CENTER PC (NPI 1396944559) is a healthcare organization registered as a chiropractor in East Peoria, Illinois and active in the NPI registry since July 2007. The organization lists Thomas K Dickerson, Owner, as its authorized official.

NPPES Registry Identity

NPI1396944559

Entity TypeOrganization

Primary Taxonomy111N00000X

Legal Business NameDICKERSON CHIROPRACTIC AND WELLNESS CENTER PC

Location Address100 N MAIN ST, SUITE 101East Peoria, IL 61611-2533

Mailing Address100 N Main St, Suite 101East Peoria, IL 61611-2533 · (309) 699-7900

Phone(309) 699-7900

Organization SubpartNo

Authorized OfficialThomas K DickersonOwner · (309) 699-7900

Enumeration DateJuly 17, 2007

Last NPPES UpdateAugust 6, 2007

✔ NPI 1396944559 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.

100 N MAIN ST, East Peoria, IL 61611

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dickerson Chiropractic And Wellness Center Pc 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 Dickerson Chiropractic And Wellness Center PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Thomas Dickerson, D.C., D.I.C.C.P.

Chiropractic

NPI 1548300163

2362 WASHINGTON RD
Washington, IL 61571

(309) 745-8612

✔ Accepts Medicare5.1 mi

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 Dickerson Chiropractic And Wellness Center PC's NPI number?

The NPI number for Dickerson Chiropractic And Wellness Center PC is 1396944559. It was assigned to this organization in the NPPES registry on July 17, 2007.

Where is Dickerson Chiropractic And Wellness Center PC located?

Dickerson Chiropractic And Wellness Center PC is located at 100 N Main St Suite 101, East Peoria, IL 61611. The listed phone number is (309) 699-7900.

What is Dickerson Chiropractic And Wellness Center PC's specialty?

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

Is Dickerson Chiropractic And Wellness Center PC enrolled in Medicare?

Yes. Dickerson Chiropractic And Wellness Center PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dickerson Chiropractic And Wellness Center PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Dickerson Chiropractic And Wellness Center PC. 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 Dickerson Chiropractic And Wellness Center PC was last updated on August 6, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.