MEDICARE: ELSIE R. WALKER M. D., P. C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036068920	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	110022723	OTHER	IL	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3160223878	OTHER	IL	BLUE CROSS AND BLUE SHIEL
2	242068	OTHER	IL	HARMONY
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184805277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELSIE R. WALKER M. D., P. C.

Provider Business Mailing Address
First Line	:	8015 S LUELLA AVE
Second Line	:	SUITE 212
City	:	CHICAGO
State	:	IL
Zip	:	60617-1199
Country	:	US
Telephone Number	:	773-721-0470
Fax Number	:	773-721-0470

Provider Business Practice Location Address
First Line	:	8015 S LUELLA AVE
Second Line	:	SUITE 212
City	:	CHICAGO
State	:	IL
Zip	:	60617-1199
Country	:	US
Telephone Number	:	773-721-0470
Fax Number	:	773-721-0470

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ELSIE RUTH WALKER THOMAS
Credential	:	M.D.
Telephone Number	:	773-721-0470

Provider Enumeration Date	:	11/17/2007
Last Update Date	:	06/01/2011

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