Walking In His Purpose

Specialty details in registry · Lynwood, IL

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At a glance

19609 Lake Shore Dr, Lynwood, IL 60411-1473

NPPES record updated May 17, 2021. Public records can lag behind changes at a practice.

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Practice location

19609 Lake Shore Dr
Lynwood, IL 60411-1473

Professional details: NPI, taxonomy & registry record

NPI1134793839

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 320900000X
Enumeration date: May 17, 2021
Record updated: May 17, 2021

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

320900000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

19609 Lake Shore Dr
Lynwood, IL 60411-1473

Phone: (773) 757-3814

Mailing address

19609 LAKE SHORE DR

LYNWOOD, IL 604111473

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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