Individual
CULLEN WHICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2300 N EDWARD ST, DECATUR, IL 62526-4192
(217) 876-2575
Mailing address
304 COREY LN, CHAMPAIGN, IL 61822-1130
(217) 972-4546
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209018652
IL
Other
Enumeration date
02/05/2019
Last updated
02/05/2019
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