Individual provider Active NPI

Jessica M Trenkle, PT,DPT, PCS

  • Physical Therapist
  • Evanston, IL
National Provider Identifier
1194957910
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070017173 Issued in IL
Practice address
827 South Blvd
Evanston, IL 60202-2810
Phone
(847) 902-0251
NPI assigned
Aug 12, 2009
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070017173 IL Primary

Addresses

Primary practice location

827 South Blvd
Evanston, IL 60202-2810

Mailing address

827 South Blvd
Evanston, IL 60202-2810
Phone (847) 902-0251

Other names 1

  • Jessica Marie Stuckey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070017173ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194957910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 SOUTH BLVD",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022810",
            "telephone_number": "847-902-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 SOUTH BLVD",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022810",
            "telephone_number": "847-902-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENKLE",
        "first_name": "JESSICA",
        "middle_name": "M",
        "credential": "PT,DPT, PCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "STUCKEY",
            "middle_name": "MARIE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.