MR. JASON EMIL WULF LATC CSCS NPI 1427026533

NPI Information

NPI: 1427026533
Provider Name: MR. JASON EMIL WULF, LATC, CSCS
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
211 HORTON FIELDHOUSE
NORMAL, IL
ZIP 61790
Phone: (309) 438-3284
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MR. Jason Emil Wulf, LATC, CSCS is a specialist in Normal, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MR. Jason Emil Wulf, LATC, CSCS NPI is 1427026533. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

211 HORTON FIELDHOUSE
NORMAL, IL
ZIP 61790-001
Phone: (309) 438-3284

The enumeration date for this NPI number is 3/14/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		96002168	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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