Provider Demographics
NPI:1407085400
Name:RICHARDS, WHITNEY LEIGH (MA, ATC)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:LEIGH
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 DITTMER LN APT 2D
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60046-8693
Mailing Address - Country:US
Mailing Address - Phone:847-850-9050
Mailing Address - Fax:
Practice Address - Street 1:150 DITTMER LN APT 2D
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:IL
Practice Address - Zip Code:60046-8693
Practice Address - Country:US
Practice Address - Phone:847-850-9050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer