Individual provider Active NPI

Jacob Allen Dunker, D.C.

  • Chiropractor
  • Pekin, IL
National Provider Identifier
1326390295
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012272 Issued in IL
Practice address
1030 Court St
Pekin, IL 61554-4806
Phone
(309) 346-8008
NPI assigned
Oct 2, 2012
Last updated
Aug 26, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012272 IL Primary

Addresses

Primary practice location

1030 Court St
Pekin, IL 61554-4806

Mailing address

1030 Court St
Pekin, IL 61554-4806
Phone (309) 346-8008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150309002294 IL Practitioner - Chiropractic 7911151600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1030 Court St
Pekin, IL 61554-4806
Phone (309) 346-8008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Illinois Chiropractic, P.C. Chiropractor CurrentSince Oct 22, 2012 Accepting new patients
Central Il Chiropractic, LTD Chiropractor CurrentSince Sep 2, 2014 Accepting new patients

Locations

1030 Court St
Pekin, IL 61554
Phone (309) 346-8008

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1326390295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 COURT ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615544806",
            "telephone_number": "309-346-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 COURT ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615544806",
            "telephone_number": "309-346-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNKER",
        "first_name": "JACOB",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-02",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.