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Miroslaw Walo, Md Sc
Mental Health Clinic/Center (Including Community Mental Health Center) in Northfield, Illinois
NPI 1679772479

Miroslaw Walo, Md Sc is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Skokie, IL and is specialized in Mental Health (Including Community Mental Health Center). Miroslaw Walo, Md Sc practices in Northfield, IL. The NPI Number for Miroslaw Walo, Md Sc is 1679772479 and holds a License No. 042618878 (Illinois).

The current practice location address for Miroslaw Walo, Md Sc is 1737 Winnetka Ave, Northfield, IL and can be reached out via phone at 847-324-4300 and via fax at 847-324-4303.

Location: 1737 Winnetka Ave, Northfield, IL, 60077
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1679772479
Provider Name
Miroslaw Walo, Md Sc
Credential
Provider Entity Type
Organization
Address
1737 Winnetka Ave, Northfield, IL, 60077
Phone Number
847-324-4300
Fax Number
847-324-4303
Provider Enumeration Date
07/12/2007
Last Update Date
02/15/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
036093864 05 IL
institution
Provider Business Practice Location Address Details
Address
1737 Winnetka Ave
City
Northfield
State
Illinois
Zip
60093-3318
Phone Number
847-324-4300
Fax Number
847-324-4303
person
Provider Business Mailing Address Details
Address
1737 Winnetka Ave
City
Northfield
State
Illinois
Zip
60093-3318
Phone Number
847-324-4300
Fax Number
847-324-4303
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Prescribing (Medical)
Taxonomy
103TP0016X
License No.
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Definition
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
042618878 (Illinois)
Definition
Definition to come...
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