Whiteside, Mckenna
Whiteside, Mckenna is an individual health care provider with primary practice located at 88 S Main St , Glen Carbon IL 62034-1415. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Whiteside, Mckenna can be contacted via phone (618) 288-8085.Contact Information
Primary practice address
88 S Main St
Glen Carbon IL 62034-1415
Phone: (618) 288-8085
Fax: (618) 288-8959
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1275260135 |
|---|---|
| LBN Legal business name | Whiteside, Mckenna |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2022 |
| Last updated | Aug 2nd, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275260135 | NPPES |
| Illinois | MEDICAID | 4A00-IPI-032 |
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