MEDICARE: CHYANN WEGNER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer
2	111N00000X	Chiropractor	6289-12	WI

General Provider Information

NPI Number	:	1154822047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHYANN WEGNER DC

Provider Business Mailing Address
First Line	:	1101 WAUONA TRL
Second Line	:
City	:	PORTAGE
State	:	WI
Zip	:	53901-1407
Country	:	US
Telephone Number	:	608-575-5245
Fax Number	:

Provider Business Practice Location Address
First Line	:	641 LATTON LN STE A
Second Line	:
City	:	PORTAGE
State	:	WI
Zip	:	53901-1078
Country	:	US
Telephone Number	:	608-742-1300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2018
Last Update Date	:	06/23/2025

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Directions to “ CHYANN WEGNER DC” Practice Location

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