Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Cody Wickenhauser, PT, DPT

Individual provider Physical Therapist · NPI 1811364052

Cody Wickenhauser, PT, DPT is a Physical Therapist in Bloomington, Illinois. Licensed in Illinois. Registered with an NPI since 2015.

Licensed in
IL
In the registry since
2015
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

2406 E Empire St
Bloomington, IL 61704-3630
Phone: (309) 663-9300
Fax: (309) 663-6993
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 070.021534 (IL)

Record details

NPI number1811364052
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedAugust 24, 2015
Last updated in NPPESAugust 24, 2015

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