Organization
ELSIE R. WALKER M. D., P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELSIE RUTH WALKER THOMAS M.D. (OWNER)
(773) 721-0470
Entity
Organization
Contact information
Practice address
8015 S LUELLA AVE, SUITE 212, CHICAGO, IL 60617-1199
(773) 721-0470
(773) 721-0470
Mailing address
8015 S LUELLA AVE, SUITE 212, CHICAGO, IL 60617-1199
(773) 721-0470
(773) 721-0470
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036068920
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036068920
—
IL
01
—
110022723
RAIL ROAD MEDICARE
IL
01
—
242068
HARMONY
IL
01
—
3160223878
BLUE CROSS AND BLUE SHIEL
IL
Enumeration date
11/17/2007
Last updated
06/01/2011
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