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Individual

DR. CLYDE WHITING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1501 S CALIFORNIA AVE, CHICAGO, IL 60608-1732
(773) 257-6097
Mailing address
8336 S HERMITAGE AVE, CHICAGO, IL 60620-4629
(312) 933-6075

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036129320
IL

Other

Enumeration date
01/04/2012
Last updated
01/04/2012
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