Provider Demographics
NPI:1841615929
Name:DR RALPH WHETSTINE PSYD & ASSOC PC
Entity Type:Organization
Organization Name:DR RALPH WHETSTINE PSYD & ASSOC PC
Other - Org Name:CENTER FOR CONSCIOUS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:WHETSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-825-6108
Mailing Address - Street 1:830 E HIGGINS RD STE 104H
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4792
Mailing Address - Country:US
Mailing Address - Phone:708-825-6037
Mailing Address - Fax:708-515-4471
Practice Address - Street 1:830 E HIGGINS RD
Practice Address - Street 2:SUITE 104H
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4797
Practice Address - Country:US
Practice Address - Phone:708-825-6108
Practice Address - Fax:815-521-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008198103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL7676Medicare UPIN