Provider Demographics
NPI:1891087540
Name:WHETSTINE, RALPH W (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:W
Last Name:WHETSTINE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 E HIGGINS RD
Mailing Address - Street 2:SUITE 104H
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4797
Mailing Address - Country:US
Mailing Address - Phone:708-825-6108
Mailing Address - Fax:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008198103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical