Provider Demographics
NPI:1912026584
Name:WHITMAN, KAREN HAZEL (APN)
Entity Type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:HAZEL
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 S MICHGAN AVE
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604
Mailing Address - Country:US
Mailing Address - Phone:800-660-4425
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:4437 S CICERO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-4333
Practice Address - Country:US
Practice Address - Phone:312-758-1435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN203734163W00000X
TNAPN19281363LA2200X
IL209000988363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse