Individual
BRYAN WALDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2711 LEONARD DR STE 101, VALPARAISO, IN 46383-7121
(219) 462-6001
(219) 464-6060
Mailing address
120 W 22ND ST STE 200, OAK BROOK, IL 60523-1563
(630) 575-5000
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01064566A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200889490
—
IN
Enumeration date
08/31/2006
Last updated
04/29/2025
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