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General NPI Number Information
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NPI Number | 1467111591
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Entity Type | Individual
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Provider Name | GRACE WHITBY
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Gender | Female
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Dates
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Enumeration Date | 12/16/2021
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 4908 N ELSTON AVE
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City | CHICAGO
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State | IL
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Zip | 60630-2506
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Country | US
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Telephone | 773-205-8505
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Fax |
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Provider Business Mailing Address
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Address Line | 2653 N SPAULDING AVE APT 2E
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City | CHICAGO
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State | IL
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Zip | 60647-1418
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Country | US
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Telephone | 479-249-5480
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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