DR. ROBERT SCOTT WALLER PSYD - NPI 1174014625

Q: What is Robert Waller's NPI number?

The NPI number for Robert Waller is 1174014625. It was assigned to this individual provider in the NPPES registry on May 21, 2018.

Q: What is Robert Waller's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Robert Waller was last updated on July 31, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

On this page

About Dr. Robert Scott Waller Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ROBERT SCOTT WALLER PSYD (NPI 1174014625) is an individual clinical provider in Chicago, Illinois, licensed in Illinois (071009689) and active in the NPI registry since May 2018. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1174014625

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. ROBERT SCOTT WALLERCredential: PSYD

Location Address1276 N CLYBOURN AVEChicago, IL 60610

Mailing Address1441 W Elmdale Ave Apt 1sChicago, IL 60660-2405 · (239) 248-7437

Phone(312) 337-1073

Sole ProprietorNo

Enumeration DateMay 21, 2018

Last NPPES UpdateJuly 31, 20193 updates tracked since enumeration

✔ NPI 1174014625 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in IL · 071009689

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedPsychologist · Addiction (Substance Use Disorder)Taxonomy 103TA0400X · License 071009689 (IL)

1276 N CLYBOURN AVE, Chicago, IL 60610

Open in Google Maps ↗

Secondary Practice Locations 2

Location 11525 E 53rd St Ste 623Chicago, IL 60615-4530 · Phone (239) 248-7437

Location 230 N Michigan Ave Ste 529Chicago, IL 60602-3491 · Phone (312) 629-5075

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANDREW KOCH FNP

Nurse Practitioner (Family)