Waller, Byron

Waller, Byron is an individual health care provider with primary practice located at 12653 S Potomac Dr , Plainfield IL 60585-9620. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Waller, Byron can be contacted via phone (312) 218-8483.

Contact Information

Primary practice address
12653 S Potomac Dr Plainfield IL 60585-9620
Phone: (312) 218-8483
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 180005749 Illinois
Behavioral Health & Social Service Providers / Professional 101YP2500X 180005749 Illinois
Behavioral Health & Social Service Providers / Counselor 101Y00000X 180005749 Illinois

Profile Details

NPI number 1013064328
LBN Legal business name Waller, Byron
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2007
Last updated May 8th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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