Provider Demographics
NPI:1376717207
Name:MATTHEW WALN, INC
Entity Type:Organization
Organization Name:MATTHEW WALN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:WALN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-876-3812
Mailing Address - Street 1:850 MEADOWVIEW XING
Mailing Address - Street 2:UNIT 1B
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-2514
Mailing Address - Country:US
Mailing Address - Phone:630-876-3812
Mailing Address - Fax:
Practice Address - Street 1:850 MEADOWVIEW XING
Practice Address - Street 2:UNIT 1B
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-2514
Practice Address - Country:US
Practice Address - Phone:630-876-3812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty