MIROSLAW WALO, MD SC (NPI# 1679772479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679772479 |
| Entity Type | Organization |
| Organization Name | MIROSLAW WALO, MD SC |
| Practice Address |
4905 Old Orchard Ctr Ste 428 Skokie IL 60077-1458 |
| Mailing Address |
4905 Old Orchard Ctr Ste 428 Skokie IL 60077 |
| Practice Telephone | 8473244300 |
| Practice Fax Number | 8473244303 |
| Mailing Telephone | 8473244300 |
| Mailing Fax Number | 8473244303 |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2017-03-29 |
| Authorized Official Name | DR. MIROSLAW JAN WALO (PRESIDENT) |
| Authorized Official Telephone | 8473244300 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
042618878 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036093864 | 05 |
| Street Address |
4905 OLD ORCHARD CTR STE 428 |
| City | SKOKIE |
| State | IL |
| Zip Code | 60077-1458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437140530 | Alan Eugene Lasser | Dermatology | 4905 Old Orchard Ctr, Suite 318, Skokie, IL 60077-1425 | 2005-10-30 |
| 1023554276 | Idalia Karolina Walo | Counselor | 4905 Old Orchard Ctr, Suite428, Skokie, IL 60077-1458 | 2017-01-12 |
| 1639611056 | Anuj Lal Md Ltd | Internal Medicine | 4905 Old Orchard Ctr, Lower Level, Skokie, IL 60077-1458 | 2016-11-16 |
| 1326437039 | Lasser Dermatology, LLC | Dermatology | 4905 Old Orchard Ctr, Suite 318, Skokie, IL 60077-1458 | 2015-01-19 |
| 1679980924 | Toni Ellis Wolf, Dds, PC | Dentist | 4905 Old Orchard Ctr, Su 232, Skokie, IL 60077-1458 | 2014-07-18 |
| 1790127660 | Abc Home Health Care, Inc | Home Health | 4905 Old Orchard Ctr, Suite 736, Skokie, IL 60077-1458 | 2013-07-21 |
| 1780925305 | Gregory Kaczmarek, Md, LLC | Internal Medicine | 4905 Old Orchard Ctr, Lower Level, Skokie, IL 60077-1458 | 2013-03-06 |
| 1235401019 | Resurrection Services | General Practice | 4905 Old Orchard Ctr, Suite 634, Skokie, IL 60077-1458 | 2012-02-08 |
| 1316227655 | Sergio Rubinstein | Dentist | 4905 Old Orchard Ctr, Suite 420, Skokie, IL 60077-1458 | 2011-08-18 |
| 1427348903 | Alan J. Nidetz | Dentist | 4905 Old Orchard Ctr, Suite 420, Skokie, IL 60077-1458 | 2011-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740835347 | Tharani Theivakumar | Dentist | 5225 W. Touhy Ave, Skokie, IL 60077 | 2019-08-09 |
| 1780179838 | Total Renal Care Inc | Clinic/Center | 8950 Gross Point Rd Ste 300, Skokie, IL 60077 | 2018-06-29 |
| 1811481070 | Joseph Rubin | Counselor | 7929 Lincoln Ave Ste 202, Skokie, IL 60077 | 2018-06-20 |
| 1245721067 | Lipnick Orthopaedics S.c. | Orthopaedic Surgery | 4856 Oakton Street, Skokie, IL 60077 | 2018-05-29 |
| 1376034991 | Karen Bradley | Nurse Practitioner | 5143 Coyle Ave, Skokie, IL 60077 | 2018-05-21 |
| 1093217036 | Arnold Arellano | Pedorthist | 5202 Old Orchard Road, N100, Skokie, IL 60077 | 2018-03-06 |
| 1043722408 | Carolyn Mary Jarozewski I | Registered Nurse | 5250 N.old Orchard Road Suite 300, 5250 N.old Orchard Road Suite 300, Skokie, IL 60077 | 2017-10-25 |
| 1841718400 | Katie Kluga | Nurse Practitioner | 9977 Woods Drive Suite 300, Skokie, IL 60077 | 2017-09-05 |
| 1265950091 | Larry Asher Sidel | Counselor | 9530 Lamon Pl.apt 110, Skokie, IL 60077 | 2017-08-31 |
| 1578088639 | Eleni Toumplis | Pharmacist | 4955 Dempster St, Skokie, IL 60077 | 2017-08-10 |
| Find all providers in zip 60077 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548408586 | Meryl Lipton | Psychologist | 4711 Golf Rd, Suite 1100, Skokie, IL 60076-1224 | 2009-01-29 |
| 1992923304 | Rush North Shore Pain Center | Psychologist | 9701 Knox Ave, Suite 103, Skokie, IL 60076-1256 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891237434 | Wylie & Associates Behavioral Health LLC | Psychologist | 118 S Seminary St, Collinsville, IL 62234-2634 | 2016-11-14 |
| 1104341999 | Clarity Clinic Arlington Heights, LLC | Psychologist | 2101 S Arlington Heights Rd Ste 116, Arlington Heights, IL 60005-4142 | 2017-08-14 |
| 1215330022 | Accessmydoc Inc | Psychologist | 1900 E Golf Rd, Suite 950, Schaumburg, IL 60173-5834 | 2014-10-07 |
| 1831511690 | The Chicago Integrative Center for Psychiatry LLC | Psychologist | 900 North Shore Dr, Suite 120, Lake Bluff, IL 60044-2243 | 2014-01-14 |
| 1083841076 | Aeries Healthcare of Illinois Physician Group | Psychologist | 8311 W Roosevelt Rd, Forest Park, IL 60130 | 2009-06-17 |
| 1558539387 | Nehal Psychiatric Group, Inc | Psychologist | 7425 Janes Ave, Suite 200, Woodridge, IL 60517-2356 | 2008-02-14 |
| 1174739122 | Gretchen L. Cromer, Md PC | Psychologist | 3302 41st St, Moline, IL 61265-7830 | 2007-05-15 |
| 1447472493 | Richard P Weber Psy.d. | Psychologist | 1105 W Park Ave, Suite 2, Libertyville, IL 60048-2567 | 2007-05-02 |
| 1417994690 | Michael H. Hansen | Psychologist | 3860 W Ogden Ave, Chicago, IL 60623-2460 | 2006-05-31 |
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| 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.