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General NPI Number Information
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NPI Number | 1376075689
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Entity Type | Individual
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Provider Name | CATHERINE WALTERS L.AC.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2017
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Last Update Date | 05/16/2018
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Provider Practice Location Address
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Address Line | 19 SOUTH LASALLE STREET SUITE 503
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City | CHICAGO
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State | IL
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Zip | 60603
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Country | US
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Telephone | 312-236-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 2922 W EASTWOOD AVE
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City | CHICAGO
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State | IL
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Zip | 60625-3722
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Country | US
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Telephone | 773-809-7663
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 198.001392
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License Number State | IL
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