Active NPI
Denise Walt, MD
- Psychiatry Physician
- Highland Park, IL
National Provider Identifier
1447470620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036084112
- Practice address
- 1770 1St St
Suite 330
Highland Park, IL 60035-3200 - Phone
- (847) 433-8065
- Fax
- (847) 433-8447
- NPI assigned
- Apr 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036084112 | IL | Primary |
Addresses
Primary practice location
1770 1St St
Suite 330
Highland Park, IL 60035-3200
Mailing address
1770 1St St
Suite 330
Highland Park, IL 60035-3200
Phone (847) 433-8065
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036084112 | IL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fraden Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Neurology Physician
- Highland Park, IL
- NPI 1851623342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447718400000",
"number": "1447470620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1770 1ST ST",
"address_2": "SUITE 330",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600353200",
"telephone_number": "847-433-8065",
"fax_number": "847-433-8065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1770 1ST ST",
"address_2": "SUITE 330",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600353200",
"telephone_number": "847-433-8065",
"fax_number": "847-433-8447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALT",
"first_name": "DENISE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-27",
"last_updated": "2015-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036084112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.