Healthcare Provider Details

I. General information

NPI: 1346742657
Provider Name (Legal Business Name): DR. WHITNEY SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 10/07/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 SOUTH WILKE ROAD 203D
ARLINGTON HEIGHTS IL
60004-1534
US

IV. Provider business mailing address

125 SOUTH WILKE ROAD 203D
ARLINGTON HEIGHTS IL
60004-1534
US

V. Phone/Fax

Practice location:
  • Phone: 224-310-9864
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: