Healthcare Provider Details

I. General information

NPI: 1922773829
Provider Name (Legal Business Name): KATIE LOUISE WALKER APRN CNM DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S WOOD ST # MC808
CHICAGO IL
60612-4325
US

IV. Provider business mailing address

4140 W 31ST ST
CHICAGO IL
60623-4803
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-0533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number209.023792
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.464432
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: