Provider Demographics
NPI:1275037319
Name:WHELAN, ELEANORE (DNP)
Entity Type:Individual
Prefix:
First Name:ELEANORE
Middle Name:
Last Name:WHELAN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2113 N KEDZIE BLVD UNIT B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2741
Mailing Address - Country:US
Mailing Address - Phone:248-924-0689
Mailing Address - Fax:
Practice Address - Street 1:3219 W CARROLL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-2031
Practice Address - Country:US
Practice Address - Phone:872-588-3580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.017386207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine