Individual
G WESLEY WHITE
Active
Individual
G WESLEY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036051494
IL
207RI0200X
Infectious Disease Physician
Primary
036051494
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635822
BCBS PROVIDER ID
IL
05
—
036051494
—
IL
01
—
206147
MEDICARE PTAN (GROUP
IL
01
—
K49356
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
P00448441
RAILROAD MEDICARE
IL
01
—
P00661626
RR MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
05/31/2006
Last updated
12/27/2013
Update your record
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