Provider Demographics
NPI:1306288840
Name:HERRIG, WHITNEY S (PA-C)
Entity type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:S
Last Name:HERRIG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4648 N WINTHROP AVE APT 2S
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-7051
Mailing Address - Country:US
Mailing Address - Phone:314-409-4999
Mailing Address - Fax:773-702-3538
Practice Address - Street 1:5841 S MARYLAND AVE
Practice Address - Street 2:MC 6098
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1447
Practice Address - Country:US
Practice Address - Phone:773-702-0141
Practice Address - Fax:773-702-3538
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.004688363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant