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Individual

DEMETRIOUS WALKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2430 ATHENS RD, OLYMPIA FIELDS, IL 60461-1954
(708) 541-9785
Mailing address
PO BOX 1175, CALUMET CITY, IL 60409-1175
(708) 541-9785

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary

Other

Enumeration date
08/25/2019
Last updated
08/25/2019
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