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General NPI Number Information
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NPI Number | 1023637667
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Entity Type | Individual
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Provider Name | ERIN WALSH
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Gender | Female
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 5013 N OAK PARK AVE
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City | CHICAGO
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State | IL
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Zip | 60656-3739
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Country | US
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Telephone | 773-580-6301
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Fax |
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Provider Business Mailing Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 773-580-6301
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.022052
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License Number State | IL
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