Provider Demographics
NPI:1639718570
Name:WHISKER, EMMA MARIE
Entity Type:Individual
Prefix:MISS
First Name:EMMA
Middle Name:MARIE
Last Name:WHISKER
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 1:105 BOULDER DR
Mailing Address - Street 2:
Mailing Address - City:GRIDLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61744-9271
Mailing Address - Country:US
Mailing Address - Phone:309-310-2278
Mailing Address - Fax:
Practice Address - Street 1:105 BOULDER DR
Practice Address - Street 2:
Practice Address - City:GRIDLEY
Practice Address - State:IL
Practice Address - Zip Code:61744-9271
Practice Address - Country:US
Practice Address - Phone:309-310-2278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer