Jack M. Whitney, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Practice address

777 Park Ave W
Emergency Dept
Highland Park, IL 60035-2433

Phone

(847) 480-3784

Fax

(847) 480-2845

NPI assigned

Nov 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  NPD (past)

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780750216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "EVANSTON HOSPITAL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-1206",
            "fax_number": "847-570-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 PARK AVE W",
            "address_2": "EMERGENCY DEPT",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352433",
            "telephone_number": "847-480-3784",
            "fax_number": "847-480-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITNEY",
        "first_name": "JACK",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damen Wellen, LCSW
• Wendie T Dalberg LCSW and Associates
• Stacy Wexler, MSW, LCSW
• Kathleen White, DNP, APRN, FNP-B
• Tuere Whitmore, LMT
• Vernetta Williams, LPC
• Samantha Jean Williamson, AU.D.
• Gary Norman Wilner, MD
• Robert Withington
• Deborah Springman Wojcik, MSW, LCSW

• Emergency Medicine Physician in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Emergency 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.