| Mr Nicholas Ryan Walters, PA-C | |
|
7600 W College Dr, Palos Heights, IL 60463-1001 | |
| (708) 361-0600 | |
| Not Available |
| Full Name | Mr Nicholas Ryan Walters |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 7600 W College Dr, Palos Heights, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144284449 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 085.004177 (Illinois) | Primary |
| 2255A2300X | Specialist/technologist - Athletic Trainer | 096-002105 (Illinois) | Secondary |
| Entity Name | Emergency Medical Associates of Palos, Ltd. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285918128 PECOS PAC ID: 1052578366 Enrollment ID: O20120127000880 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Nicholas Ryan Walters, PA-C 510 W Elle St, Romeoville, IL 60446-5295 Ph: (630) 723-8699 | Mr Nicholas Ryan Walters, PA-C 7600 W College Dr, Palos Heights, IL 60463-1001 Ph: (708) 361-0600 |
Mohammed Abdul Mannan Ansari, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 7350 W College Dr Ste 103, Palos Heights, IL 60463 Phone: 708-694-9876 |
Amanda N Murray, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12251 S 80th Ave Ste 1520, Palos Heights, IL 60463 Phone: 708-923-4200 Fax: 708-923-4201 |
Ann Marie Cleary, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 11845 Southwest Hwy Unit 12, Palos Heights, IL 60463 Phone: 708-923-5422 Fax: 708-923-5458 |
Madeleine Grace Subach, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12251 S 80th Ave Ste 1520, Palos Heights, IL 60463 Phone: 708-923-4200 Fax: 708-923-4201 |
Nicole Denee Joy, P.A.-C. Physician Assistant Medicare: Medicare Enrolled Practice Location: 7808 W College Dr, Suite 1sw, Palos Heights, IL 60463 Phone: 708-361-0730 Fax: 708-361-0740 |
Prutha R Rajyaguru, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12255 S 80th Ave Ste 203, Palos Heights, IL 60463 Phone: 708-827-2021 Fax: 708-827-2241 |
Kacianna Hardsock, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 12251 S 80th Ave Ste 1520, Palos Heights, IL 60463 Phone: 708-923-4200 Fax: 708-923-4201 |