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Individual
DR. WALTER R. MAIN
Active
Individual
DR. WALTER R. MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
4068
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048240
HEALTH ALLIANCE
IL
01
—
5722676
BLUE CROSS/BLUE SHIELD IN
IL
01
—
7862458
AETNA INSURANCE
IL
Enumeration date
08/01/2006
Last updated
10/07/2015
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