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Individual

DR. WALDO EMERSON HARVEY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3000 N HALSTED, SUITE 303, CHICAGO, IL 60657-5190
(773) 525-1900
(773) 525-1911
Mailing address
1020 S 22ND AVENUE, BELLWOOD, IL 60104-2504
(708) 704-4532
(773) 525-1900

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1623742
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/28/2006
Last updated
07/09/2007
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