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Contact Information

JAN E WENKE, MSN, MA, PRN, LATC
1207 S OAK ST
CHAMPAIGN, IL61820-6901
 Phone: 515-460-6400
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
 

Orthopedic

163WX0800X
Indicates primary specialty

NPI Profile & details for JAN E WENKE · (Female)

NPI # 1780376806
Status Active
Credentials MSN, MA, PRN, LATC
Entity Individual
Enumeration date 05/25/2023
Last updated 05/25/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 041374169
  • IL License # 096003087
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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