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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