Peter J. Waller, DO Valid NPI

Individual provider · Sports Medicine (Family Medicine) Physician · Skokie, IL

NPI

1902291644

Type

Individual (Type 1)

Primary specialty

Sports Medicine (Family Medicine) Physician (Family Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207QS0010X

License number

036150318 (IL)

Sex

Male

Sole proprietor

No

Enumerated

2015-03-31

Last updated

2019-10-10