DR. RICHARD JOSEPH WALLYN (NPI# 1033343132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033343132 |
| Entity Type | Individual |
| Full Name | DR. RICHARD JOSEPH WALLYN |
| Credential | MD |
| Practice Address |
1300 Brassie Ave. Flossmoor IL 60422-1812 |
| Practice Telephone | 7087981356 |
| Practice Fax Number | 7087981356 |
| Mailing Telephone | 7087981356 |
| Mailing Fax Number | 7087981356 |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2009-05-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
036-32156 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1300 BRASSIE AVE. |
| City | FLOSSMOOR |
| State | IL |
| Zip Code | 60422-1812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274310 | Miranda Home Health Care Inc | Nursing Care | 19150 S. Kedzie Ave, 203, Flossmoor, IL 60422 | 2020-08-06 |
| 1285256172 | Bp Behavioral Services, LLC | Behavioral Analyst | 2222 Marston Lane, Flossmoor, IL 60422 | 2020-05-13 |
| 1891164133 | Lauren Simpson | Behavioral Analyst | 19530 Kezie Avenue, Flossmoor, IL 60422 | 2015-09-16 |
| 1437541190 | Keshawn Gardner | Specialist/Technologist, Other | 1248 Berry Ln, Flossmoor, IL 60422 | 2015-03-04 |
| 1770989717 | Naomi Kelly | Behavioral Analyst | 1930 Kedzie Avenue, Flossmoor, IL 60422 | 2014-11-18 |
| 1093059453 | Miranda Home Health Care Inc | In Home Supportive Care | 19150 S Kedzie Ave, 203, Flossmoor, IL 60422 | 2012-11-23 |
| 1285981506 | Restorative Life Services, LLC | Social Worker | 169624 Governors Highway, Flossmoor, IL 60422 | 2012-08-06 |
| 1063786457 | Gwyneeda Carter-sidberry | Pharmacist | 1443 Selkirk Street, Flossmoor, IL 60422 | 2012-03-02 |
| 1053682021 | Alfonso Javier Medina Sr. | Anesthesiology | 3141 Stonegate Ct., Flossmoor, IL 60422 | 2012-01-23 |
| 1912121161 | Anthony J Maoloni | Dentist | 19815 Governors Highway, Orthodontic Associates Ltd Suite 1, Flossmoor, IL 60422 | 2007-04-12 |
| Find all providers in zip 60422 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477752160 | Arthur Hoffman | Internal Medicine | 2652 Broadway Ave, Evanston, IL 60201 | 2007-07-13 |
| 1659300796 | Abhin Singla | Internal Medicine | 801 N Larkin Ave Ste 101, Joliet, IL 60435 | 2006-07-01 |
| 1841238979 | Mysore N Shivaram | Internal Medicine | 6901 Cermak Rd, Berwyn, IL 60402-2160 | 2006-06-02 |
| 1659342665 | Albert C Tanlim | Internal Medicine | 845 S 4th St, Roberts Clinic Ltd, Watseka, IL 60970-1628 | 2006-01-28 |
| 1184189672 | Calumet Counseling and Dui Services,inc | Internal Medicine | 1010 W 95th St, Chicago, IL 60643-1522 | 2019-02-08 |
| 1407395346 | Bhs Physician Services of Illinois PC | Internal Medicine | 1237 E 1600 North Rd, Gilman, IL 60938-6112 | 2017-02-13 |
| 1588929525 | Opioid Addiction Recovery Services PC | Internal Medicine | 755 S Milwaukee Ave, Suite 210, Libertyville, IL 60048-3253 | 2012-07-05 |
| 1376819565 | Sahar Eftekhar | Internal Medicine | 1 E Superior St Ste 306, Chicago, IL 60611-2595 | 2012-04-01 |
| 1942585468 | Ngu Md. Wellness Ltd. | Internal Medicine | 400 E Randolph St, Apt 2711, Chicago, IL 60601-7329 | 2011-10-15 |
| 1184934036 | Mary S Wenzel | Internal Medicine | 3730 N Lake Shore Dr, Chicago, IL 60613-4236 | 2010-10-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.