Provider Demographics
NPI:1942344114
Name:WHELAN, JILL (APN)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:WHELAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:TORNABENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:721 W LAKE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-2035
Mailing Address - Country:US
Mailing Address - Phone:630-757-4010
Mailing Address - Fax:630-757-4011
Practice Address - Street 1:721 W LAKE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2035
Practice Address - Country:US
Practice Address - Phone:630-757-4010
Practice Address - Fax:630-757-4011
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-005421363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics