Individual
DAVID CLAYTON WALTHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP, MSN, BSN
Contact information
Practice address
1340 S DAMEN AVE, CHICAGO, IL 60608-1169
(312) 997-7200
Mailing address
1340 S DAMEN AVE, CHICAGO, IL 60608-1169
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.017198
IL
Other
Enumeration date
02/13/2018
Last updated
02/13/2018
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