Individual
DR. BYRON WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
12653 S POTOMAC DR, PLAINFIELD, IL 60585-9620
(312) 218-8483
Mailing address
12653 S POTOMAC DR, PLAINFIELD, IL 60585-9620
(312) 218-8483
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
180005749
IL
101YM0800X
Mental Health Counselor
180005749
IL
101YP2500X
Professional Counselor
Primary
180005749
IL
Other
Enumeration date
01/05/2007
Last updated
05/08/2024
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