Individual
ABIGAIL WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(708) 283-5500
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
(847) 390-4757
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.018373
IL
363LA2100X
Acute Care Nurse Practitioner
209018373
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041385178
ILLINOIS REGISTERED NURSE LICENSE
IL
01
—
209018373
ILLINOIS ADVANCED PRACTICE NURSE LICENSE
IL
Enumeration date
10/18/2018
Last updated
10/08/2024
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