Provider Demographics
NPI:1033277017
Name:WHYTE, BONNIE LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:LEE
Last Name:WHYTE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:BONNIE
Other - Middle Name:LEE
Other - Last Name:WHYTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:800 E NORTHWEST HWY
Mailing Address - Street 2:STE 206
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-3457
Mailing Address - Country:US
Mailing Address - Phone:847-696-1100
Mailing Address - Fax:847-696-9515
Practice Address - Street 1:950 LEE ST
Practice Address - Street 2:STE 202
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-6532
Practice Address - Country:US
Practice Address - Phone:847-696-1100
Practice Address - Fax:847-696-9515
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071003482103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL958060Medicare ID - Type Unspecified