Provider Demographics
NPI:1013983618
Name:WHITNEY, DAVID H (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:H
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:866-630-9882
Mailing Address - Fax:920-682-5810
Practice Address - Street 1:3253 S HARLEM AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3073
Practice Address - Country:US
Practice Address - Phone:262-898-4400
Practice Address - Fax:708-788-6884
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-063522207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL761421Medicare UPIN
ILD13409Medicare UPIN