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General NPI Number Information
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NPI Number | 1679915839
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Entity Type | Organization
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Legal Business Name | GAMOFF WALKER PEDIATRICS INC.
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Dates
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Enumeration Date | 07/29/2013
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Last Update Date | 01/19/2014
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Provider Practice Location Address
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Address Line | 1820 W WEBSTER AVE 202
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City | CHICAGO
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State | IL
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Zip | 60614-2934
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Country | US
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Telephone | 847-722-5616
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Fax |
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Provider Business Mailing Address
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Address Line | 529 S CHESTNUT AVE
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-1801
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Country | US
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Telephone | 847-722-5616
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HILLARY WALKER
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Credential |
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Telephone | 847-722-5616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 056-008439
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License Number State | IL
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