Provider Demographics
NPI:1043299084
Name:ALM, WALTER ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:ALAN
Last Name:ALM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1795 GRANDSTAND PL
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4980
Mailing Address - Country:US
Mailing Address - Phone:847-742-0500
Mailing Address - Fax:847-742-2501
Practice Address - Street 1:1795 GRANDSTAND PL
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4980
Practice Address - Country:US
Practice Address - Phone:847-742-0500
Practice Address - Fax:847-742-2501
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Not Answered213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
T35495Medicare UPIN
236680Medicare ID - Type Unspecified