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Organization
JEAN L. WALSH FAMILY PRACTITIONER, LTD.
Active
Organization
JEAN L. WALSH FAMILY PRACTITIONER, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEAN L WALSH D.O. (FAMILY PRACTITIONER)
(815) 838-2888
Entity
Organization
Contact information
Practice address
16151 WEBER ROAD, SUITE 201, CREST HILL, IL 60403-0863
(815) 838-2888
(815) 838-0222
Mailing address
16151 WEBER RD, SUITE 201, CREST HILL, IL 60403-0863
(815) 838-2888
(815) 838-0222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-089648
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02226675
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/23/2006
Last updated
10/27/2008
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