IndividualActive
Peter Waller, DO
NPI 1902291644 · Sports Medicine (Family Medicine) Physician · Skokie, IL
Provider details
- NPI number
- 1902291644
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- 036150318 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
9650 Gross Point Rd. Suite 2900
Skokie, IL 60076
Phone: (847) 866-7846
Fax: (224) 251-2905
Approximate (ZIP-level) locationGet directions
Mailing address
9650 Gross Point Rd. Suite 2900
Skokie, IL 60076
Registry dates
- Enumerated
- 2015-03-31
- Last updated
- 2019-10-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.