Individual
MARTIN WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
395 W LAKE ST, ELMHURST, IL 60126-1508
(630) 530-2988
Mailing address
1129 S HERMITAGE AVE, ROOM 101, CHICAGO, IL 60612-2607
(312) 355-4367
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
11 815001
IL
Other
Enumeration date
02/05/2016
Last updated
02/05/2016
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