Doctor Name: | DR. ROBERT JOHN WALSH |
NPI Number: | 1003117920 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | 071.005985 |
Business Practice Address: | 4300 Lincoln Ave Suite K Rolling Meadows, IL - 600081157 |
Business Phone Number: | 7084361047 |
Business Fax Number: | 8477011560 |
Mailing Address: | 4300 Lincoln Ave, Suite K ROLLING MEADOWS |
State: | IL |
Postal Code: | 60008 |
Phone Number: | 7084361047 |
Fax Number: | 8477011560 |
NPI Enumeration Date: | 11/09/2010 |
NPI Last Update Date: | 11/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 071.005985 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |