Individual
MR. JOSEPH HADEN WHITSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
ILLINOIS STATE UNIVERSITY, CAMPUS BOX 7160, NORMAL, IL 61790-0001
(309) 438-3282
(309) 438-3603
Mailing address
BRADLEY UNIVERSITY, 1501 W. BRADLEY AVENUE, PEORIA, IL 61625-0001
(309) 677-2688
(309) 677-3288
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096-002150
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096-002150
STATE LICENSE
IL
Enumeration date
03/09/2006
Last updated
05/01/2016
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