Provider Demographics
NPI:1013311166
Name:WHATLEY POPE, HELEN KATHARINE (LMT, CZB)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:KATHARINE
Last Name:WHATLEY POPE
Suffix:
Gender:F
Credentials:LMT, CZB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3506 CYPRESS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-7948
Mailing Address - Country:US
Mailing Address - Phone:217-220-7673
Mailing Address - Fax:
Practice Address - Street 1:3506 CYPRESS CREEK RD
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-7948
Practice Address - Country:US
Practice Address - Phone:217-220-7673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-18
Last Update Date:2014-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.015058172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist