Provider Demographics
NPI:1144569393
Name:WHALEY, KELCIE MARIE (DPT)
Entity Type:Individual
Prefix:DR
First Name:KELCIE
Middle Name:MARIE
Last Name:WHALEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:KELCIE
Other - Middle Name:MARIE
Other - Last Name:MCKAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:312-640-0407
Practice Address - Street 1:503 WESTBURY DR
Practice Address - Street 2:STE 3
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2726
Practice Address - Country:US
Practice Address - Phone:319-337-4325
Practice Address - Fax:319-337-0608
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2015-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA005057225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist