Individual
LAURA L WALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4999 OLD ORCHARD SHOPPING CENTER, STE F12 & F13, SKOKIE, IL 60077
(312) 219-2230
(415) 252-7176
Mailing address
711 W NORTH AVE FL 1, CHICAGO, IL 60610-1042
(312) 337-1982
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036106292
IL
Other
Enumeration date
08/11/2006
Last updated
03/14/2025
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