Cornelius Edward Whalen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036059817 Issued in IL

Practice address

925 18TH St
Charleston, IL 61920-2938

Phone

(217) 345-2123

Fax

(217) 345-3907

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184774564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 18TH ST",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202938",
            "telephone_number": "217-345-2123",
            "fax_number": "217-345-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 18TH ST",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202938",
            "telephone_number": "217-345-2123",
            "fax_number": "217-345-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEN",
        "first_name": "CORNELIUS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036059817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036059817",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walmart Inc.
• Julie Anne Walters, MS, LSW
• Michael Warner, MS.ED, LCPC, CADC
• Mary Katherine Weber, DMD
• Blake Westra, D.M.D.
• Christina L. White, FNP
• Ellie White
• Larry R. White, PHD
• Shirley Anne White
• Jane Elizabeth Wilson, MA, LCPC

• Family Medicine Physician in Charleston, IL
• Providers in Charleston, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.