Provider Demographics
NPI:1659901577
Name:WHITSELL, EMILY (DC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WHITSELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:GAUDET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:21527 129TH AVE N
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:IL
Mailing Address - Zip Code:61242-9707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21527 129TH AVE N
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:IL
Practice Address - Zip Code:61242-9707
Practice Address - Country:US
Practice Address - Phone:563-219-1191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-20
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor