Organization
JESSICA WHELAN LLC
Active
Parent organization
HOLON INCLUSIVE HEALTH SYSTEM
Other names
Holon Inclusive Health System
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOLON INCLUSIVE HEALTH SYSTEM
Authorized official
DR. JESSICA ANN WHELAN BA,FPMHNP-BC, RN-BC (CEO)
(314) 470-1220
Entity
Organization
Contact information
Practice address
301 S MAIN ST, DUPO, IL 62239-1325
(314) 470-1220
(833) 914-0432
Mailing address
16549 CLAYTON RD, WILDWOOD, MO 63011-1720
(636) 236-5128
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
2084P0800X
Psychiatry Physician
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR1100X
Research Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760018774
NPI
IL
01
—
691674
MCKESSON SUBMITTER
IL
01
—
91674
MCKESSON SUBMITTER
IL
01
—
STL70408459
QUEST ACCOUNT
IL
Enumeration date
05/19/2020
Last updated
09/01/2021
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