Individual
MRS. MARY M WALTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1167 WILMETTE AVE, SUITE 201, WILMETTE, IL 60091-2643
(847) 251-7350
(847) 853-2600
Mailing address
269 LOCUST RD, WINNETKA, IL 60093-3608
(847) 441-5619
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
IL
106H00000X
Marriage & Family Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206905
MEDICARE
IL
Enumeration date
08/03/2006
Last updated
09/11/2025
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