JUSTINE ANTOINETTE WALKER


Address: 650 Phoenix Center Dr, Phoenix, IL 60426-2408
Phone: 7082259900

JUSTINE ANTOINETTE WALKER (NPI# 1588608095) 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) 1588608095
Entity Type Individual
Full Name JUSTINE ANTOINETTE WALKER
Credential FNP
Practice Address 650 Phoenix Center Dr
Phoenix
IL 60426-2408
Mailing Address 17700 Devon Dr
Country Club Hills
IL 60478-4845
Practice Telephone 7082259900
Practice Fax Number 7082259997
Mailing Telephone 7732944183
Enumeration Date 2006-06-15
Last Update Date 2009-01-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
209-000804 IL Physician Assistants & Advanced Practice Nursing Providers

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Office Location

Street Address 650 PHOENIX CENTER DR
City PHOENIX
State IL
Zip Code 60426-2408

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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Competitor

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City PHOENIX
Zip Code 60426

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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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