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JACQUELINE WUDTKE
NPI 1780535872
Nurse Practitioner - Acute Care in Peoria, IL

Active since February 05, 2026PECOS EnrolledAccepts Medicare Assignment
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-2000 Get Directions Write a Review

NPPES record last updated: February 5, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jacqueline Wudtke NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE WUDTKE (NPI 1780535872) is an individual acute care provider in Peoria, Illinois, licensed in Illinois (209033941) and active in the NPI registry since February 2026. She is enrolled in Medicare PECOS, is affiliated with Saint Francis Medical Center, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1780535872
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameJACQUELINE WUDTKE
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address320 Miller AveChampaign, IL 61821-2444
Phone(309) 655-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 5, 2026
NPPES CertifiedFebruary 5, 2026
✔ NPI 1780535872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in IL · 209033941
530 NE GLEN OAK AVE, Peoria, IL 61637
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacqueline Wudtke is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002386307
PECOS Enrollment IDI20260528001116
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jacqueline Wudtke reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Osf Multi-Specialty Group
7.4 mi
Internal Medicine
8600 N STATE ROUTE 91
Peoria, IL 61615
  • Reassigned Medicare billing, Illinois enrollment
  • 2,944 clinicians in this Medicare group
NPI 1922445527 (309) 683-5050

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140067
Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61637 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HAMID MAHMOOD ZIA M.D
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Peoria County (309) 624-9011
THOMAS JAMES MCMORROW MD
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109
ABIGAIL V. WELU DO
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-6710
DR. JAMES DANIEL DEWAR D.O.
Internal Medicine (Interventional Cardiology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-7257

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacqueline Wudtke's NPI number?

The NPI number for Jacqueline Wudtke is 1780535872. It was assigned to this individual provider in the NPPES registry on February 5, 2026.

Where is Jacqueline Wudtke located?

Jacqueline Wudtke practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 655-2000.

What is Jacqueline Wudtke's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Jacqueline Wudtke enrolled in Medicare?

Yes. Jacqueline Wudtke is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jacqueline Wudtke's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Wudtke reassigns Medicare benefits to Osf Multi-Specialty Group (Peoria, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacqueline Wudtke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jacqueline Wudtke affiliated with any hospitals?

According to CMS data, Jacqueline Wudtke is affiliated with Saint Francis Medical Center.

When was this NPI record last updated?

The NPPES record for Jacqueline Wudtke was last updated on February 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.