Individual
DR. JEAN L WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
741 E LINCOLN AVE, HINCKLEY, IL 60520-9500
(815) 286-9256
Mailing address
2357 SEQUOIA DR, AURORA, IL 60506-6222
(630) 859-6800
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036089648
IL
207Q00000X
Family Medicine Physician
Primary
036089648
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02226675
BLUE CROSS BLUE SHIELD
IL
05
—
036089648
—
IL
01
—
04515143
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/17/2007
Last updated
02/22/2017
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