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Individual

HOLLY R WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
420 NE GLEN OAK AVE STE 401, PEORIA, IL 61603-3168
(309) 676-8123
(309) 676-8455
Mailing address
420 NE GLEN OAK AVE STE 401, PEORIA, IL 61603-3168
(309) 676-8123
(309) 676-8455

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
085001719
IL
363A00000X
Physician Assistant
Primary
085001719
IL
363AM0700X
Medical Physician Assistant
085001719
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0850017179
IL
01
P00300733
RAILROAD MEDICARE
IL
Enumeration date
03/09/2007
Last updated
02/04/2026
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