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General NPI Number Information
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NPI Number | 1124067335
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Entity Type | Individual
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Provider Name | WALTER S FALKOWSKI MD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 7900 N MILWAUKEE AVE SUITE 17
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City | NILES
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State | IL
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Zip | 60714-3159
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Country | US
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Telephone | 847-470-0297
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Fax | 847-470-0302
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Provider Business Mailing Address
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Address Line | 7900 N MILWAUKEE AVE SUITE 17
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City | NILES
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State | IL
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Zip | 60714-3159
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Country | US
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Telephone | 847-470-0297
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Fax | 847-470-0302
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 036054644
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License Number State | IL
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