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Individual

MS. ELIZABETH A WALSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 563-1358
Mailing address
123 N DESPLAINES ST APT 1010, CHICAGO, IL 60661-2305
(561) 308-1639

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9106939
FL
363AM0700X
Medical Physician Assistant
017211-1
NY
363AM0700X
Medical Physician Assistant
Primary
085006176
IL

Other

Enumeration date
11/15/2012
Last updated
10/10/2017
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