Basic Information
| Provider Information | |||||||||
| NPI: | 1831231976 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | L.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 806 S LOOMIS ST APT A | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606074006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3124793482 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1414 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MELROSE PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601603902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7086810073 | ||||||||
| FaxNumber: | 7086813958 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | IL | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.