Healthcare Provider Details

I. General information

NPI: 1013413285
Provider Name (Legal Business Name): IAN WALKER WINTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 LUTHER LN
PARK RIDGE IL
60068-1270
US

IV. Provider business mailing address

700 COMMERCE DR STE 500
OAK BROOK IL
60523-8736
US

V. Phone/Fax

Practice location:
  • Phone: 847-723-8030
  • Fax:
Mailing address:
  • Phone: 847-698-0600
  • Fax: 847-698-0601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number036164037
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: