Provider Demographics
NPI:1861964579
Name:CARTON, WHITNEY GRAY (DPT)
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:GRAY
Last Name:CARTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:NICOLE
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:13041 E 1900TH ST
Mailing Address - Street 2:
Mailing Address - City:ATKINSON
Mailing Address - State:IL
Mailing Address - Zip Code:61235-9513
Mailing Address - Country:US
Mailing Address - Phone:815-383-6340
Mailing Address - Fax:
Practice Address - Street 1:1051 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:KEWANEE
Practice Address - State:IL
Practice Address - Zip Code:61443-8354
Practice Address - Country:US
Practice Address - Phone:309-852-7931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070020542225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist