Individual
KACIE DALE WHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
900 N 1ST ST, SPRINGFIELD, IL 62702-3749
(217) 280-6954
Mailing address
900 N 1ST ST, SPRINGFIELD, IL 62702-3749
(217) 280-6954
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041496029
IL
363LF0000X
Family Nurse Practitioner
Primary
209032516
IL
Other
Enumeration date
06/12/2025
Last updated
08/26/2025
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