Active NPI
Jennifer C Wicklatz, APRN
- Nurse Practitioner
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209.024499
- Practice address
- 111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597 - Phone
- (888) 731-8994
- NPI assigned
- Sep 29, 2021
- Last updated
- Sep 15, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11015667 | FL | |
| Nurse Practitioner | 363L00000X | 209.024499 | IL | Primary |
Addresses
Primary practice location
111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597
Mailing address
111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597
Phone (888) 731-8994
Other practice location 1
111 N Orange Ave Ste 900
Orlando, FL 32801-2307
Phone (888) 731-8994
Other practice location 2
450 Alaskan Way S # 9452
Seattle, WA 98104-3387
Phone (888) 731-8994
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063184026 | Other | IL | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.024499 | IL | MD | Nurse Practitioner |
| 11015667 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Integrative Womens Care PC | Past | Accepting new patients |
Locations
1715 N Division St
Morris, IL 60450
Phone (815) 431-3410
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
Interoperability endpoints
- jennifer.wicklatz.1@27069.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
dba patton pharmacy and v&s variety
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
dba Midi Health PC
- Obstetrics & Gynecology Physician
- Palo Alto, CA
- NPI 1972266732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789430400000",
"number": "1063184026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 W JACKSON BLVD STE 1700",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606043597",
"telephone_number": "888-731-8994",
"fax_number": "833-775-1861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 W JACKSON BLVD STE 1700",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606043597",
"telephone_number": "888-731-8994"
}
],
"practiceLocations": [
{
"address_1": "111 N Orange Ave Ste 900",
"address_purpose": "LOCATION",
"city": "Orlando",
"state": "FL",
"postal_code": "328012307",
"country_code": "US",
"telephone_number": "888-731-8994",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "450 Alaskan Way S # 9452",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981043387",
"country_code": "US",
"telephone_number": "888-731-8994",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WICKLATZ",
"first_name": "JENNIFER",
"middle_name": "C",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-29",
"last_updated": "2026-09-15",
"certification_date": "2026-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "11015667",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209.024499",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1063184026",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.