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Individual

DR. KIMBERLY MARIA WALTON-VERNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1645 COTTAGE GROVE AVE, FORD HEIGHTS, IL 60411-3818
(708) 753-5800
(708) 753-5910
Mailing address
1645 COTTAGE GROVE AVE, FORD HEIGHTS, IL 60411-3818
(708) 753-5800
(708) 753-5910

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036097904
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036097904
STATE MEDICAL LICENSE NUM
IL
Enumeration date
07/26/2006
Last updated
05/04/2021
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