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

MS. Holly D Wickenhauser, ATC

Individual provider Athletic Trainer · NPI 1659546422

MS. Holly D Wickenhauser, ATC is an Athletic Trainer in Bloomington, Illinois. Licensed in Illinois. Registered with an NPI since 2008.

Licensed in
IL
In the registry since
2008
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

1111 Trinity Ln Ste 111
Bloomington, IL 61704-8111
Phone: (309) 663-6461
Fax: (309) 663-5711
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 096.001891 (IL)

Record details

NPI number1659546422
Entity typeIndividual (Type 1)
GenderFemale
Credentials ATC
Sole proprietorNo
NPI enumeratedApril 23, 2008
Last updated in NPPESJanuary 4, 2017

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