Jessica Whelan
Group Psychotherapist Nurse Practitioner - Psychiatric/Mental Health
301 S Main St
Dupo
, Illinois 62239-1325
Jessica Whelan
Group Psychotherapist Nurse Practitioner - Psychiatric/Mental Health
301 S Main St
Dupo
, Illinois 62239-1325
(833) 914-0432
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About
Features
Specialties
- Group Psychotherapist
- Nurse Practitioner - Psychiatric/Mental Health
Languages spoken
- English
Location
First Address
- Jessica Whelan
- 16549 Clayton Rd Ste 10
- Wildwood, MO
- Zip : 63011-1720
- Fax : (833) 914-0432
- Phone : (314) 470-1220
Second Address
- Jessica Whelan
- 301 S Main St
- Dupo, IL
- Zip : 62239-1325
- Fax : (833) 914-0432
- Phone : (314) 470-1220
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 103TP2701X | Group Psychotherapist | 277000634 | IL |
| N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 2013029034 | MO |
| Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 277000634 | IL |
National Provider Identifier
| NPI | 1033544747 |
|---|---|
| Provider Name | Jessica Whelan |
| First Address | Wildwood, MO 63011-1720 |
| Second Address | Dupo, IL 62239-1325 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/09/2013 |
| Last Update Date | 01/09/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 277000634 | STATE LICENSE IL (01) | IL |
| 377000614 | IL PRESCRIBING LICENSE (01) | IL |
| 6555912834012 | SURESCRIPTS (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.