Wala Abu-Mallouh, DC
Individual provider Active NPI Chiropractor · Romeoville, IL
NPI 1902327232 · NPPES record last updated Jun 27, 2017
Key facts
- NPI
- 1902327232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038013114 (IL)
- Practice address
- 188 Morgan CT
Romeoville, IL 60446-4082 - Phone
- (815) 603-4602
- NPI assigned
- Jun 27, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038013114 | IL | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038013114 | IL | Yes |
Addresses
Primary practice location
188 Morgan CT
Romeoville, IL 60446-4082
Mailing address
188 Morgan CT
Romeoville, IL 60446-4082
Other providers in Romeoville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.