DR. JEREMY R CLARK D.C.
NPI 1710018395
Chiropractor in Vandalia, IL

Q: What is Jeremy Clark's NPI number?

The NPI number for Jeremy Clark is 1710018395. It was assigned to this individual provider in the NPPES registry on March 8, 2007.

Q: What is Jeremy Clark's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jeremy Clark was last updated on June 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since March 08, 2007

100 N KENNEDY BLVD, VANDALIA, IL 62471(618) 531-1141 Get Directions Write a Review

NPPES record last updated: June 3, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Jeremy R Clark D.c. NPPES

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

DR. JEREMY R CLARK D.C. (NPI 1710018395) is an individual chiropractor in Vandalia, Illinois, licensed in Illinois (IL038-009768) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1710018395

Entity TypeIndividualMale

Primary Taxonomy111N00000X

Provider Legal NameDR. JEREMY R CLARKCredential: D.C.

Location Address100 N KENNEDY BLVDVandalia, IL 62471-2314

Mailing Address100 N Kennedy BlvdVandalia, IL 62471-2314 · (618) 531-1141

Phone(618) 531-1141

Sole ProprietorNo

Enumeration DateMarch 8, 2007

Last NPPES UpdateJune 3, 2011

✔ NPI 1710018395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in IL · IL038-009768

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 KENNEDY BLVD, Vandalia, IL 62471

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Other Identifiers 1

Medicare PINK19248IL

Other Providers at the Same Location NPPES

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

PAIN RELIEF CENTER OF VANDALIA INC

Chiropractor

100 N KENNEDY BLVD
VANDALIA, IL 62471

Fayette County (618) 283-1100

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 Jeremy Clark's NPI number?

The NPI number for Jeremy Clark is 1710018395. It was assigned to this individual provider in the NPPES registry on March 8, 2007.

Where is Jeremy Clark located?

Jeremy Clark practices at 100 N Kennedy Blvd, Vandalia, IL 62471. The listed phone number is (618) 531-1141.

What is Jeremy Clark's specialty?

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

When was this NPI record last updated?

The NPPES record for Jeremy Clark was last updated on June 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.