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DR. ANGELICA CHRISTINE CLARK DC
NPI 1417734385
Chiropractor in Chicago, IL

Active since September 13, 2023
4555 N LINCOLN AVE, CHICAGO, IL 60625(773) 598-4387(312) 267-1827 Get Directions Write a Review

NPPES record last updated: September 13, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Angelica Christine Clark Dc NPPES

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

DR. ANGELICA CHRISTINE CLARK DC (NPI 1417734385) is an individual chiropractor in Chicago, Illinois, licensed in Illinois (038.014044) and active in the NPI registry since September 2023.

NPPES Registry Identity

NPI1417734385
Entity TypeIndividualFemale
Primary Taxonomy111N00000X
Provider Legal NameDR. ANGELICA CHRISTINE CLARKCredential: DC
Location Address4555 N LINCOLN AVEChicago, IL 60625-2102
Mailing Address447 Valley View RdLake Barrington, IL 60010-1645 · (630) 709-1851
Phone(773) 598-4387
Fax(312) 267-1827
Sole ProprietorNo
Enumeration DateSeptember 13, 2023
NPPES CertifiedSeptember 13, 2023
✔ NPI 1417734385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in IL · 038.014044
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.
4555 N LINCOLN AVE, Chicago, IL 60625
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Angelica Christine Clark Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Angelica Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Active Wellness, LLC
Same address
Chiropractor
4555 N LINCOLN AVE
Chicago, IL 60625
  • Reassigned Medicare billing, Illinois enrollment
  • 61 clinicians in this Medicare group
NPI 1902162662 (773) 328-8153

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

DR. ANNEMARIE FILISKY LECLAIR D.C.
Chiropractor
4555 N LINCOLN AVE
CHICAGO, IL 60625
Cook County (773) 598-4387
KELLY KIRLES L.AC
Acupuncturist
4555 N LINCOLN AVE
CHICAGO, IL 60625
Cook County (773) 273-6734
SCOTT LYMAN DC
Chiropractor
4555 N LINCOLN AVE
CHICAGO, IL 60625
Cook County (773) 328-8153
DR. JOSHUA ELLIOTT BUTTON DC
Chiropractor
4555 N LINCOLN AVE
CHICAGO, IL 60625
Cook County (773) 328-8153
PATRYCJA MARIA DANIEL LAC
Acupuncturist
4555 N LINCOLN AVE
CHICAGO, IL 60625
Cook County (773) 598-4387
DR. KATELYN GIANCOLA D.C.
Chiropractor
4555 N LINCOLN AVE
CHICAGO, IL 60625
Cook County (773) 328-8153
VITALIY KOPYTKO L.AC
Acupuncturist
4555 N LINCOLN AVE
CHICAGO, IL 60625
Cook County (773) 273-6736
DR. KENICE ANNE BROUGHMAN D.C.
Chiropractor (Nutrition)
4555 N LINCOLN AVE
CHICAGO, IL 60625
Cook County (386) 763-2763

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 Angelica Clark's NPI number?

The NPI number for Angelica Clark is 1417734385. It was assigned to this individual provider in the NPPES registry on September 13, 2023.

Where is Angelica Clark located?

Angelica Clark practices at 4555 N Lincoln Ave, Chicago, IL 60625. The listed phone number is (773) 598-4387.

What is Angelica Clark's specialty?

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

Is Angelica Clark enrolled in Medicare?

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

Which organization bills Medicare for Angelica Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Angelica Clark reassigns Medicare benefits to Active Wellness, LLC (Chicago, IL). The 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 Angelica Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Angelica Clark was last updated on September 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.