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NPI Code Detail

MEDICARE: JESSICA N WYKER PT

MEDICARE: JESSICA N WYKER PT
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
1225100000XPhysical Therapist302293CA
2225100000XPhysical Therapist2305214565VA

General Provider Information

NPI Number : 1598434011
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA N WYKER PT
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number : 866-370-8206
Fax Number :
Provider Business Practice Location Address
First Line : 201 BULIFANTS BLVD STE B
Second Line :
City : WILLIAMSBURG
State : VA
Zip : 23188-5731
Country : US
Telephone Number : 757-229-9740
Fax Number : 757-229-9741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2021
Last Update Date : 12/12/2025

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