Miroslaw Walo, MD SC

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

042618878 Issued in IL

Legal business name

MIROSLAW WALO, MD SC

Practice address

1737 Winnetka Ave
Northfield, IL 60093-3318

Phone

(847) 324-4300

Fax

(847) 324-4303

NPI assigned

Jul 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Miroslaw Jan Walo, M.D.NPI 1700954294

Title

President

Phone

(847) 324-4300

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Neuropsychiatric Health Connection Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Miroslaw Jan Walo, MD

  • Child & Adolescent Psychiatry Physician
  • Wilmette, IL
  • NPI 1700954294
  Medicare reassignment Authorized official
• Robert McCarthy, MD

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1942275912
  NPD (past)
• Marjorie Lee Hoelker, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Rocky River, OH
  • NPI 1124123013
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1679772479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 OLD ORCHARD CTR",
            "address_2": "STE 428",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60077",
            "telephone_number": "847-324-4300",
            "fax_number": "847-324-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 WINNETKA AVE",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933318",
            "telephone_number": "847-324-4300",
            "fax_number": "847-324-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIROSLAW WALO, MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "WALO",
        "authorized_official_first_name": "MIROSLAW",
        "authorized_official_middle_name": "JAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-324-4300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "IL",
            "license": "042618878",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093864",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neuropsychiatric Health Connection",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colleen Miller
• Madison Jean Miller
• Akosua Mills, LSW
• Richard T Milne
• Kevin Jeffery Miretzky, MSW
• Emily Misar
• Ashley Mittelman, LCSW
• Alpa Vaghasiya Modi, DO
• Barbara Mokrzycka-Pys, D.C.
• Samuel Moltz, M.D.

• Prescribing (Medical) Psychologist in Northfield, IL
• Providers in Northfield, IL by specialty
• Prescribing (Medical) Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.