Individual
KAYLA BERNICE WHITWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
251 MARKETPLACE DR STE 1, FREEBURG, IL 62243-4082
(618) 539-0067
Mailing address
739 N JEFFERSON ST STE 200, MASCOUTAH, IL 62258-1447
(618) 566-8810
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085011071
IL
Other
Enumeration date
02/04/2025
Last updated
09/02/2025
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