MARY KATHLEEN WALSH


Address: 1611 W Harrison St, Chicago, IL 60612-4861
Phone: 8776326637

MARY KATHLEEN WALSH (NPI# 1225677404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225677404
Entity Type Individual
Full Name MARY KATHLEEN WALSH
Credential PA-C
Practice Address 1611 W Harrison St
Chicago
IL 60612-4861
Mailing Address 2604 William Dr
Valparaiso
IN 46385-8182
Practice Telephone 8776326637
Mailing Telephone 2192467981
Enumeration Date 2020-01-05
Last Update Date 2020-01-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207XX0005X Orthopaedic Surgery
Specialization: Sports Medicine
085007391 IL Allopathic & Osteopathic Physicians

Other Providers MARY WALSH

NPI Name Taxonomy Address Enumeration
1710588637 Mary Ellen Walsh Physical Therapy Assistant 134 Greaton Rd, West Roxbury, MA 02132-1427 2020-11-06
1417579871 Mary Elizabeth Walsh Physician Assistant 1790 Broadway Fl 8, New York, NY 10019-1412 2020-05-08
1487930269 Mary Therese Walsh Registered Nurse 120 Muirfield Rd, Rockville Centre, NY 11570-2701 2011-10-25
1861645517 Mary Patricia Walsh Massage Therapist 848 Palmer Rd, Apt. 3c, Bronxville, NY 10708-3322 2008-10-28
1619021169 Mary J. Walsh Speech-Language Pathologist 2310 Cobb Dr, Tallahassee, FL 32312-3168 2007-01-22
1114903564 Mary M. Walsh Occupational Therapist 1991 Fordham Dr Ste 102, Fayetteville, NC 28304-3774 2005-12-19
1093712317 Mary T Walsh Nurse Anesthetist, Certified Registered 310 E. 14th Street, Ny Eye & Ear Infirmary, New York, NY 10003 2005-07-01
1750980520 Mary Walsh Licensed Practical Nurse 20 Old Turnpike Rd Ste 307, Nanuet, NY 10954-2530 2020-10-22
1861090698 Mary Walsh Registered Nurse 151 Hillside Ave, Staten Island, NY 10304-1700 2020-10-14
1235603721 Mary Ann Walsh Counselor 1545 Hotel Cir S Ste 300, San Diego, CA 92108-3414 2019-01-17

Office Location

Street Address 1611 W HARRISON ST
City CHICAGO
State IL
Zip Code 60612-4861

Providers in the same location

NPI Name Taxonomy Address Enumeration
1235138546 Thomas J Nielsen Otolaryngology 1611 W Harrison St, Suite 550, Chicago, IL 60612-4861 2005-07-19
1699376996 Lauren Kennerly Registered Nurse 1611 W Harrison St, Chicago, IL 60612-4861 2020-11-03
1407417900 Megan Merritt Specialist/Technologist 1611 W Harrison St, Chicago, IL 60612-4861 2019-06-25
1881253292 Ellen Rohan Physician Assistant 1611 W Harrison St, Chicago, IL 60612-4861 2019-06-10
1588136154 Elle Steele Physician Assistant 1611 W Harrison St, Chicago, IL 60612-4861 2018-12-20
1720591704 Tricia Jacobs Speech-Language Pathologist 1611 W Harrison St, Chicago, IL 60612-4861 2017-11-13
1811415227 Emily Marie Krogel Nurse Practitioner 1611 W Harrison St, Chicago, IL 60612-4861 2017-09-06
1104376912 Paige Maher Physician Assistant 1611 W Harrison St, Ste 300, Chicago, IL 60612-4861 2016-10-05
1902350929 Leah Kathleen Sparker Specialist/Technologist 1611 W Harrison St, Orthopedic Building Suite 530, Chicago, IL 60612-4861 2016-08-08
1215380209 Brittany Lynch Physician Assistant 1611 W Harrison St, Chicago, IL 60612-4861 2016-07-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144839739 Sandhya Shri Kannayiram Internal Medicine 1901w Harrison Street, Chicago, IL 60612 2020-07-29
1568080174 Nastaran Ordoyo Haghani Rad Student in an Organized Health Care Education/Training Program 1950 W. Polk Street, Room 6203, Chicago, IL 60612 2020-07-09
1669090403 Marianne Gagnon-konamna Student in an Organized Health Care Education/Training Program 1950 West Polk Street, Chicago, IL 60612 2020-07-08
1922625672 Tanya Montgomery Nee Brown Pediatrics 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 2020-06-29
1124643028 Ashley Swan Dentist 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 2020-06-16
1831711381 Baillie Anne Bronner Obstetrics & Gynecology 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 2020-05-07
1154942449 Keisha Davell Cole Case Manager/Care Coordinator 612 S Western Ave Unit 1, Chicago, IL 60612 2020-04-28
1275153777 Isac Lim Student in an Organized Health Care Education/Training Program 1234 S. Wells, Chicago, IL 60612 2020-04-24
1578183414 Zachary Belden Student in an Organized Health Care Education/Training Program Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 2020-04-21
1548880560 Christina Nunez Student in an Organized Health Care Education/Training Program 801 S. Paulina Street, M/c 850, Chicago, IL 60612 2020-04-20
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Taxonomy Information

Taxonomy Code 207XX0005X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery
Specialization Sports Medicine

Taxonomy Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063048395 Dr Ouilife LLC Orthopaedic Surgery 640 S Federal St Apt 410, Chicago, IL 60605-1800 2020-03-18
1568851251 Benjamin Scott Kester Orthopaedic Surgery 1725 W Harrison St Ste Rush, Chicago, IL 60612-3841 2015-01-18
1568419463 Mark K. Bowen Orthopaedic Surgery 680 N Lake Shore Dr Ste 924, Chicago, IL 60611 2006-05-27
1902367642 Sebastian Ko Orthopaedic Surgery 4646 N Marine Dr, Chicago, IL 60640-5759 2019-03-26
1073080909 Kierra La Shawn Bruno-rodgers Orthopaedic Surgery 712 N Dearborn St, Chicago, IL 60654-3846 2018-10-29
1124505508 Robert Morris University Illinois Orthopaedic Surgery 401 S State St, Chicago, IL 60605-1229 2018-07-27
1992220404 Chicago Sports Medicine Institute Orthopaedic Surgery 875 N Dearborn St, Chicago, IL 60610-7377 2017-08-04
1417330242 Nicholas Anthony Trasolini Orthopaedic Surgery 1611 W Harrison St Ste 400, Chicago, IL 60612-4861 2015-06-29
1679960843 John Lloyd Fritch Orthopaedic Surgery 5841 S Maryland Ave # Mc3079, Chicago, IL 60637-1443 2015-04-24
1083000905 Blake Michael Bodendorfer Orthopaedic Surgery 1611 W Harrison St Ste 400, Chicago, IL 60612-4861 2015-04-07
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Competitor

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City CHICAGO
Zip Code 60612

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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