Provider Demographics
NPI:1366516551
Name:WHITNEY, RICHARD ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ANDREW
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3744 CELESTE LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-3103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2860 SHOWPLACE DR STE 110
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5059
Practice Address - Country:US
Practice Address - Phone:630-922-7777
Practice Address - Fax:630-922-8091
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007210111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU46160Medicare UPIN
ILK40574Medicare PIN