Provider Demographics
NPI:1477848497
Name:WHELAN, JILL BRADLEY (MD, FACC)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:BRADLEY
Last Name:WHELAN
Suffix:
Gender:F
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 RESNIK RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7211
Mailing Address - Country:US
Mailing Address - Phone:508-746-2900
Mailing Address - Fax:508-746-4208
Practice Address - Street 1:30 RESNIK RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7211
Practice Address - Country:US
Practice Address - Phone:508-746-2900
Practice Address - Fax:508-746-4208
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA269518207RC0000X
MA248904207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine