Healthcare Provider Details

I. General information

NPI: 1932288719
Provider Name (Legal Business Name): ROBERT LEE WALTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ROBERT LEE WALTON M.D.

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 E DELAWARE PL SUITE 1430
CHICAGO IL
60611-1495
US

IV. Provider business mailing address

60 EAST DELAWARE PLACE SUITE 1430
CHICAGO IL
60611-1495
US

V. Phone/Fax

Practice location:
  • Phone: 312-337-7795
  • Fax: 312-337-7798
Mailing address:
  • Phone: 312-337-7795
  • Fax: 312-337-7798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number036087851
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number036087851
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: