Provider Demographics
NPI:1013411677
Name:WHITE, TOYE
Entity Type:Individual
Prefix:
First Name:TOYE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12616 S BISHOP ST
Mailing Address - Street 2:
Mailing Address - City:CALUMET PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60827-6024
Mailing Address - Country:US
Mailing Address - Phone:708-972-5053
Mailing Address - Fax:
Practice Address - Street 1:840 RED COACH LANE
Practice Address - Street 2:840 RED COACH LANE
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-6006
Practice Address - Country:US
Practice Address - Phone:847-571-8691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician