Individual
SUSAN MARIE WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2160 S FIRST AVE, (FAHEY BLDG., RM. 222), MAYWOOD, IL 60153
(708) 216-3750
(708) 216-6840
Mailing address
2160 S FIRST AVE, (FAHEY BLDG., RM. 222), MAYWOOD, IL 60153
(708) 216-3750
(708) 216-6840
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071005168
IL
2084P0800X
Psychiatry Physician
71005168
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71005168
—
IL
Enumeration date
03/01/2006
Last updated
05/05/2021
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