Individual
DR. CORNELIUS EDWARD WHALEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
925 18TH ST, CHARLESTON, IL 61920-2938
(217) 345-2123
(217) 345-3907
Mailing address
925 18TH ST, CHARLESTON, IL 61920-2938
(217) 345-2123
(217) 345-3907
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036059817
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036059817
—
IL
Enumeration date
01/10/2007
Last updated
07/08/2007
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