Organization
ST JOHN HEALTH SYSTEM
Active
Other names
St John Health Chronic Headache and MIgraine Institute
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA ELLEN WHITMAN (DIRECTOR-PHYSICIAN BILLING SERVICES)
(248) 746-3218
Entity
Organization
Contact information
Practice address
27483 DEQUINDRE RD, SUITE 306, MADISON HEIGHTS, MI 48071-3491
(248) 967-7988
(248) 967-7991
Mailing address
25925 TELEGRAPH RD, 210, SOUTHFIELD, MI 48034-2518
(248) 746-3218
(248) 746-0369
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680F33073
BCBSM GROUP PIN
MI
Enumeration date
03/30/2007
Last updated
09/11/2025
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