Provider Demographics
NPI:1023127230
Name:HALEK, WALTER ANDREW (DPM)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:ANDREW
Last Name:HALEK
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 1:5618 S PULASKI RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629
Mailing Address - Country:US
Mailing Address - Phone:773-767-5707
Mailing Address - Fax:773-767-5769
Practice Address - Street 1:5618 S PULASKI RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629
Practice Address - Country:US
Practice Address - Phone:773-767-5707
Practice Address - Fax:773-767-5769
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U30526Medicare UPIN
IL974530Medicare ID - Type Unspecified