Ethan M Whitaker

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

28156 W Northpointe Pkwy Ste 125
Lake Barrington, IL 60010-2346

Phone

(224) 512-9800

Fax

(224) 512-9714

NPI assigned

Sep 25, 2018

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)

Not enrolled

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1831674910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28156 W NORTHPOINTE PKWY STE 125",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600102346",
            "telephone_number": "224-512-9800",
            "fax_number": "224-512-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "ETHAN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-25",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Tyree, NP
• Elisha Victor, APRN
• Kelly Walus
• Jiaxin Wang
• Christina Lynn Werner, DPT
• Aaron Wilkins, M.S./CCC-SLP
• Amberly K Wolber, MD
• Ning Z Wu, M.D.
• Candice L Yeargin, LCPC
• Carlos Zamudio, PA-C

• Physical Therapy Assistant in Lake Barrington, IL
• Providers in Lake Barrington, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; 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.