Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 038007210 | IL |
NPI | 1366516551 |
---|---|
Provider Name | Dr. Richard Andrew Whitney |
First Address | Naperville, IL 60564-3103 |
Second Address | Naperville, IL 60564-5059 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 18/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U46160 | (02) | IL |