Nicole L Lackner, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Practice address

7800 N Sommer St
Suite 305
Peoria, IL 61615

Phone

(309) 689-5777

Fax

(309) 689-5447

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Inner Spirit Chiropractic Inc

  • Chiropractor
  • Peoria, IL
  • NPI 1316951635
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710097530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 N SOMMER ST",
            "address_2": "SUITE 305",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "309-689-5777",
            "fax_number": "309-689-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 N SOMMER ST",
            "address_2": "SUITE 305",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "309-689-5777",
            "fax_number": "309-689-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKNER",
        "first_name": "NICOLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "7227304",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose T Kuzhively, MD
• Karen Margaret Kyle, M.D.
• Rashid Fuad Kysia, MD
• Jennifer Labanowski, LMFT
• Kaleigh Lacey
• Todd Ladage, CRNA
• Brittain Utah Ladd, DO
• Phillip J Ladd, LCPC
• Michelle L Lafollett, OT
• Angela Lagocki

• Chiropractor in Peoria, IL
• Providers in Peoria, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.