Provider Demographics
NPI:1194957910
Name:TRENKLE, JESSICA M (PT,DPT, PCS)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:TRENKLE
Suffix:
Gender:F
Credentials:PT,DPT, PCS
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:MARIE
Other - Last Name:STUCKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:827 SOUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2810
Mailing Address - Country:US
Mailing Address - Phone:847-902-0251
Mailing Address - Fax:
Practice Address - Street 1:827 SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-2810
Practice Address - Country:US
Practice Address - Phone:847-902-0251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070017173225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist