Individual
MATHEW WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 ERIE CT, OAK PARK, IL 60302-2519
(708) 283-6200
(708) 783-0920
Mailing address
3998 FAIR RIDGE DR, SUITE 300, FAIRFAX, VA 22033-2907
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036105771
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105771
—
IL
Enumeration date
08/08/2006
Last updated
03/30/2015
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