Provider Demographics
NPI:1134320393
Name:WHORLOW, MARY COLLEEN
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:COLLEEN
Last Name:WHORLOW
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 1:6006 FOREST VIEW RD
Mailing Address - Street 2:2A
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3073
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:525 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6749
Practice Address - Country:US
Practice Address - Phone:630-632-2347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0137421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical