Individual
GREGORY WALSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
4100 VETERAN'S PKWY, MCHENRY, IL 60050-4029
(815) 385-6400
Mailing address
4100 VETERAN'S PKWY, MCHENRY, IL 60050-4029
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5615096
BC/BS OF ILLINOIS
IL
Enumeration date
08/12/2006
Last updated
09/05/2007
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