Jan Elaine Wenke, MSN, MA, PRN, LATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096003087 Issued in IL

Practice address

1207 S Oak St
Champaign, IL 61820-6901

Phone

(515) 460-6400

NPI assigned

May 25, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts, Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1780376806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 S OAK ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618206901",
            "telephone_number": "515-460-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 S OAK ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618206901",
            "telephone_number": "515-460-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENKE",
        "first_name": "JAN",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "MSN, MA, PRN, LATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "IL",
            "license": "041374169",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096003087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Wells
• Tian Wells, PHARM.D
• Madisyn Welsh
• Carolyn A Welter, MSW
• Pamela Sue Wendt, LCPC
• Brian Charles Wennberg, B.A.
• Judith Werckle
• Wertz Chiropractic LTD
• Mark E. Wertz, D.C.
• Melody Wesley

• Athletic Trainer in Champaign, IL
• Providers in Champaign, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.