Individual
DAVID OTTO WALTERHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 CHILDRENS PLAZA, DIVISION OF HEMATOLOGY/ONCOLOGY BOX 30, CHICAGO, IL 60614
(773) 755-6514
(773) 880-3223
Mailing address
2300 CHILDRENS PLAZA, DIVISION OF HEMATOLOGY/ONCOLOGY BOX 30, CHICAGO, IL 60614
(773) 755-6514
(773) 880-3223
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
036079082
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036079082
—
IL
Enumeration date
03/21/2006
Last updated
09/29/2011
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