Provider Demographics
NPI:1801341714
Name:WHITEMAN, BARBARA
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:WHITEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31236 E 850 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:ARROWSMITH
Mailing Address - State:IL
Mailing Address - Zip Code:61722-9560
Mailing Address - Country:US
Mailing Address - Phone:309-727-1148
Mailing Address - Fax:309-723-6395
Practice Address - Street 1:31236 E 850 NORTH RD
Practice Address - Street 2:
Practice Address - City:ARROWSMITH
Practice Address - State:IL
Practice Address - Zip Code:61722-9560
Practice Address - Country:US
Practice Address - Phone:309-830-2722
Practice Address - Fax:309-723-6395
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-20
Last Update Date:2016-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.019151225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist