Provider Demographics
NPI:1124158076
Name:WALKER, ROBERT L (HT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:WALKER
Suffix:
Gender:M
Credentials:HT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5133 SAINT CHARLES RD
Mailing Address - Street 2:UNIT F
Mailing Address - City:BELLWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60104-1054
Mailing Address - Country:US
Mailing Address - Phone:708-547-1999
Mailing Address - Fax:708-547-1699
Practice Address - Street 1:5133 SAINT CHARLES RD
Practice Address - Street 2:UNIT F
Practice Address - City:BELLWOOD
Practice Address - State:IL
Practice Address - Zip Code:60104-1054
Practice Address - Country:US
Practice Address - Phone:708-547-1999
Practice Address - Fax:708-547-1699
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2013-04-10
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QH0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyHistology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL340440Medicare ID - Type Unspecified