Basic Information
| Provider Information | |||||||||
| NPI: | 1487967709 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NIGRIN | ||||||||
| FirstName: | WHITNEY | ||||||||
| MiddleName: | LEIGH | ||||||||
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| OtherLastName: | GRIFFITH | ||||||||
| OtherFirstName: | WHITNEY | ||||||||
| OtherMiddleName: | LEIGH | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 790 REMINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | BOLINGBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604404909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6302962223 | ||||||||
| FaxNumber: | 6307593251 | ||||||||
| Practice Location | |||||||||
| Address1: | 2021A EMMORTON RD | ||||||||
| Address2: | STE 110 | ||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210158962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105150006 | ||||||||
| FaxNumber: | 4106865447 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2010 | ||||||||
| LastUpdateDate: | 10/11/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 23366 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.