Organization Active NPI

Jessica Petersen DC LTD

  • Chiropractor
  • Oak Lawn, IL
National Provider Identifier
1205220738
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011324 Issued in IL
Legal business name
JESSICA PETERSEN DC LTD
Practice address
5170 W 95TH St
Oak Lawn, IL 60453-2458
Phone
(708) 422-3300
Fax
(708) 422-3303
NPI assigned
Mar 23, 2015
Last updated
Feb 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Authorized official

Name
Dr. Jessica R Petersen, D.C.NPI 1346480324
Title
Owner
Phone
(708) 422-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011324 IL Primary

Addresses

Primary practice location

5170 W 95TH St
Oak Lawn, IL 60453-2458

Mailing address

5170 W 95TH St
Oak Lawn, IL 60453-2458
Phone (708) 422-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150429000246 IL Part B Supplier - Clinic/Group Practice 5698094480 Receives reassigned benefits from 2 practitioners
Practice locations: Oak Lawn, IL

National Provider Directory

National Provider Directory

Locations

4907 W 95th St
Oak Lawn, IL 60453
Phone (312) 339-8346

5170 W 95th St
Oak Lawn, IL 60453
Phone (708) 422-3300

5505 W 95th St
Oak Lawn, IL 60453
Phone (708) 422-3300

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1205220738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5170 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532458",
            "telephone_number": "708-422-3300",
            "fax_number": "708-422-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532458",
            "telephone_number": "708-422-3300",
            "fax_number": "708-422-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA PETERSEN DC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-23",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-422-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.