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

Jared M Wise, PT

Individual provider Physical Therapist · NPI 1174888275

Jared M Wise, PT is a Physical Therapist in Mendota, Illinois. Licensed in Illinois. Registered with an NPI since 2012.

Licensed in
IL
In the registry since
2012
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1401 E 12th St
Mendota, IL 61342-9216
Phone: (815) 539-1409
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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 070017309 (IL)

Record details

NPI number1174888275
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedJuly 5, 2012
Last updated in NPPESJuly 5, 2012
Mailing address1401 E 12th St, Mendota, IL 61342-9216

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