person
Mr. Larry Keith Whitaker JR., PA
Medical Physician Assistant in Hoopeston, Illinois
NPI 1205870649

Larry Keith Whitaker JR. is a Medical Physician Assistant based in Urbana, IL and is specialized in Medical. Larry Keith Whitaker JR. practices in Hoopeston, IL and has the professional credentials of PA. The NPI Number for Larry Keith Whitaker JR. is 1205870649 and holds a License No. 085002550 (Illinois).

The current practice location address for Larry Keith Whitaker JR. is 801 E Orange St, Hoopeston, IL and can be reached out via phone at 217-283-5644 and via fax at 217-283-7432.

Location: 801 E Orange St, Hoopeston, IL, 61801-2500
person
Provider Profile Details
NPI Number
1205870649
Provider Name
Larry Keith Whitaker JR.
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
801 E Orange St, Hoopeston, IL, 61801-2500
Phone Number
217-283-5644
Fax Number
217-283-7432
Provider Enumeration Date
06/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
085002299 01 IL LICENSE NUMBER
096466 01 IL HEALTH ALLIANCE
777561 01 IL HEALTH LINK
institution
Provider Business Practice Location Address Details
Address
801 E Orange St
City
State
Zip
60942-1802
Phone Number
217-283-5644
Fax Number
217-283-7432
person
Provider Business Mailing Address Details
Address
801 E Orange St
City
State
Zip
60942-1802
Phone Number
217-283-5644
Fax Number
217-283-7432
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
085002550 (Illinois)
Definition
Definition to come...
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