Provider Demographics
NPI:1912984774
Name:GEORGEMILLER, WHYTE & ASSOCIATES, PC
Entity Type:Organization
Organization Name:GEORGEMILLER, WHYTE & ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WHYTE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-696-1100
Mailing Address - Street 1:800 E NORTHWEST HIGHWAY
Mailing Address - Street 2:STE 206
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-3457
Mailing Address - Country:US
Mailing Address - Phone:847-696-1100
Mailing Address - Fax:847-696-9515
Practice Address - Street 1:800 E NORTHWEST HIGHWAY
Practice Address - Street 2:STE 206
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-3457
Practice Address - Country:US
Practice Address - Phone:847-696-1100
Practice Address - Fax:847-696-9515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211062Medicare PIN