Individual
ELISE A WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3243 W 3RD ST, BLOOMINGTON, IN 47404-4835
(812) 668-1880
(812) 668-1881
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-6250
(630) 575-7450
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010313A
IN
225100000X
Physical Therapist
070013153
IL
225100000X
Physical Therapist
34746
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201064510
—
IN
Enumeration date
02/13/2007
Last updated
10/25/2016
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