Provider Demographics
NPI:1912958992
Name:WHELCHEL, JOAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:C
Last Name:WHELCHEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 N WIELAND ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-1233
Mailing Address - Country:US
Mailing Address - Phone:312-943-5312
Mailing Address - Fax:
Practice Address - Street 1:104 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-5902
Practice Address - Country:US
Practice Address - Phone:312-553-1818
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31601613OtherBLUE CROSS BLUE SHIELD
ILIL9240OtherEYEMED
IL1006811OtherAETNA
IL1268478OtherUNITED HEALTHCARE
ILE33653Medicare UPIN
ILL37703Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
IL369060Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER