Organization
MIROSLAW WALO, MD SC
Active
Organization
MIROSLAW WALO, MD SC
Active
Other names
Neuropsychiatric Health Connection
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIROSLAW JAN WALO M.D. (PRESIDENT)
(847) 324-4300
Entity
Organization
Contact information
Practice address
1737 WINNETKA AVE, NORTHFIELD, IL 60093-3318
(847) 324-4300
(847) 324-4303
Mailing address
4905 OLD ORCHARD CTR, STE 428, SKOKIE, IL 60077
(847) 324-4300
(847) 324-4303
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
042618878
IL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093864
—
IL
Enumeration date
07/12/2007
Last updated
01/24/2025
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