| Cynthia Walls, Pc | |
|
53 W Jackson Blvd Ste 626 Chicago IL 60604-3444 | |
| (773) 469-6299 | |
| Not Available |
| Full Name | Cynthia Walls, Pc |
|---|---|
| Speciality | Social Worker |
| Location | 53 W Jackson Blvd Ste 626, Chicago, Illinois |
| Authorized Official Name and Position | Cynthia Walls (PRESIDENT) |
| Authorized Official Contact | 7734696299 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cynthia Walls, Pc 3828 N Claremont Ave Chicago IL 60618-3818 Ph: (773) 469-6299 | Cynthia Walls, Pc 53 W Jackson Blvd Ste 626 Chicago IL 60604-3444 Ph: (773) 469-6299 |
| NPI Number | 1679046510 |
|---|---|
| Provider Enumeration Date | 01/03/2019 |
| Last Update Date | 01/03/2019 |
| Medicare PECOS PAC ID | 1456698307 |
|---|---|
| Medicare Enrollment ID | O20190130001615 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679046510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Cynthia A Walls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003890450 PECOS PAC ID: 1951346600 Enrollment ID: I20050622001321 |
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