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General NPI Number Information
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NPI Number | 1063870525
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Entity Type | Individual
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Provider Name | WHITNEY FRITZIE PA
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Gender | Female
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Dates
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Enumeration Date | 01/29/2016
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Last Update Date | 04/04/2018
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Provider Practice Location Address
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Address Line | 3000 N HALSTED ST SUITE 320
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City | CHICAGO
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State | IL
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Zip | 60657-5188
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Country | US
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Telephone | 773-296-3636
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Fax | 773-296-3639
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Provider Business Mailing Address
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Address Line | 900 N WESTMORELAND RD SUITE 222
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City | LAKE FOREST
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State | IL
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Zip | 60045-1674
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Country | US
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Telephone | 847-234-6121
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Fax | 847-735-8734
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 085.005717
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085.005717
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 55181
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License Number State | CA
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