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NPI Code Detail

MEDICARE: VICTORIA WALTERS M.S. CCC-SLP

MEDICARE: VICTORIA WALTERS M.S. CCC-SLP
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
1235Z00000XSpeech-Language Pathologist146.014225IL

General Provider Information

NPI Number : 1750869939
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA WALTERS M.S. CCC-SLP
Provider Business Mailing Address
First Line : 235 W VAN BUREN ST UNIT 3612
Second Line :
City : CHICAGO
State : IL
Zip : 60607-3942
Country : US
Telephone Number : 309-883-1770
Fax Number :
Provider Business Practice Location Address
First Line : 11053 S MILLARD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60655-3327
Country : US
Telephone Number : 773-253-9856
Fax Number : 773-253-9876
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2018
Last Update Date : 07/31/2018

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Directions to “ VICTORIA WALTERS M.S. CCC-SLP” Practice Location

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