Individual
ANGELA WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
468 CADIEUX RD, GROSSE POINTE, MI 48230-1507
(516) 286-2240
(309) 852-7764
Mailing address
PO BOX 747, KEWANEE, IL 61443-8354
(309) 852-7700
(309) 852-7764
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036117158
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036117158
—
IL
01
—
3715468
BCBS
IL
01
—
5101015379
LICENSE
MI
01
—
MD036117158
ILLINOIS LICENSE
IL
Enumeration date
12/11/2006
Last updated
12/21/2016
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