Provider Demographics
NPI:1821028622
Name:RUCKER-WHITAKER, CHERYL STEPHANIE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:STEPHANIE
Last Name:RUCKER-WHITAKER
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:CHERYL
Other - Middle Name:STEPHANIE
Other - Last Name:RUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:1700 W VAN BUREN ST
Mailing Address - Street 2:SUITE 470
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3218
Mailing Address - Country:US
Mailing Address - Phone:312-942-8116
Mailing Address - Fax:312-942-8119
Practice Address - Street 1:1700 W VAN BUREN ST
Practice Address - Street 2:SUITE 470
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3218
Practice Address - Country:US
Practice Address - Phone:312-942-8116
Practice Address - Fax:312-942-8119
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease