Provider Demographics
NPI:1023058435
Name:WALKER, ROBERTA J
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:J
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROBERTA
Other - Middle Name:J
Other - Last Name:HAYDUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 E OGDEN AVE
Mailing Address - Street 2:STE 126
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3633
Mailing Address - Country:US
Mailing Address - Phone:630-325-6133
Mailing Address - Fax:630-325-4751
Practice Address - Street 1:128 W VALLETTE ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-4451
Practice Address - Country:US
Practice Address - Phone:630-833-4327
Practice Address - Fax:630-833-4328
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000097237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK16755Medicare ID - Type UnspecifiedIND PROV NUMBER