Individual
VINCENT WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1801 S HIGHLAND AVE, LOMBARD, IL 60148-4932
(630) 790-1872
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-000751
IL
Other
Enumeration date
07/11/2006
Last updated
07/28/2023
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