Individual provider Active NPI

Aaron Sparks, D.C.

  • Chiropractor
  • Peoria, IL
National Provider Identifier
1124323993
Registry record updated Apr 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011882 Issued in IL
Practice address
4306 N. Sheridan Rd
Peoria, IL 61614
Phone
(309) 682-9000
NPI assigned
Jan 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH10171 FL
Chiropractor 111N00000X 038.011882 IL Primary

Addresses

Primary practice location

4306 N. Sheridan Rd
Peoria, IL 61614

Mailing address

4306 N. Sheridan Road
Peoria, IL 61614
Phone (309) 682-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH10171FLMDChiropractor
038.011882ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Realhealth Advanced Care SC CurrentSince Apr 8, 2015 Accepting new patients

Locations

328 W Washington St
East Peoria, IL 61611
Phone (309) 682-9000

4306 N Sheridan Rd
Peoria, IL 61614
Phone (309) 682-9000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1124323993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4306 N. SHERIDAN ROAD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-682-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4306 N. SHERIDAN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-682-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-25",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10171",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.