Healthcare Provider Details

I. General information

NPI: 1588984454
Provider Name (Legal Business Name): JAMES M WALTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2010
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 N SAINT CLAIR ST STE 2100
CHICAGO IL
60611-2993
US

IV. Provider business mailing address

676 N SAINT CLAIR ST STE 2100
CHICAGO IL
60611-2993
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-1800
  • Fax: 312-695-4741
Mailing address:
  • Phone: 312-695-1800
  • Fax: 312-695-4741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number036134956
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA125681
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036134956
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: