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

Mrs. Jennifer Lee Wagoner, PT

Individual provider Physical Therapist · NPI 1861785206

Mrs. Jennifer Lee Wagoner, PT is a Physical Therapist in Private Practice in Macomb, Illinois. Qualified in 2007, 19 years ago. Practices with Springfield Clinic, LLP, a 679-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
19
Licensed in
IL
In the registry since
2011
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

505 E Grant St
Macomb, IL 61455-3352
Phone: (309) 833-1733
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 625 E Monroe St, Cuba, IL 61427-5109 — (309) 785-5012

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 070015942 (IL)

Record details

NPI number1861785206
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedMay 18, 2011
Last updated in NPPESFebruary 10, 2022
Certification dateFebruary 10, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Springfield Clinic, Llp — 679 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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