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Individual

ERIN JORDAN WHITLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1725 W HARRISON ST STE 207, CHICAGO, IL 60612-3988
(312) 942-5861
Mailing address
1725 W HARRISON ST STE 207, CHICAGO, IL 60612-3988
(312) 942-5861

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085005172
IL
363A00000X
Physician Assistant
10001982A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300008097
IN
Enumeration date
09/12/2014
Last updated
01/31/2022
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