DANIEL WALLACE (NPI# 1841771292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841771292 |
| Entity Type | Individual |
| Full Name | DANIEL WALLACE |
| Practice Address |
1001 Blackhawk Dr University Park IL 60484-3213 |
| Practice Telephone | 7089257702 |
| Mailing Telephone | 7089257702 |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2018-08-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | W42016193278 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184656860 | Daniel G Wallace | Internal Medicine | 3875 Avocado Blvd, La Mesa, CA 91941 | 2006-07-06 |
| 1982608717 | Daniel J Wallace | Internal Medicine | 8750 Wilshire Blvd, Ste 350, Beverly Hills, CA 90211-2703 | 2005-06-09 |
| 1902395650 | Daniel Wallace | Social Worker | 3601 S 6th Ave, Tucson, AZ 85723-0001 | 2018-05-08 |
| 1083848063 | Daniel Charles Wallace | Family Medicine | 701 Dellwood St S, Cambridge, MN 55008-1920 | 2009-05-06 |
| 1275525875 | Daniel Leland Wallace | Family Medicine | 25 Michigan St Ne, Suite 5100, Grand Rapids, MI 49503-2515 | 2005-08-19 |
| Street Address |
1001 BLACKHAWK DR |
| City | UNIVERSITY PARK |
| State | IL |
| Zip Code | 60484-3213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447898721 | Sophia Bracey | Registered Nurse | 443 Fairway Ct, University Park, IL 60484 | 2019-12-17 |
| 1225671019 | Colin D Kirchner | Counselor | 540 Circle Dr, University Park, IL 60484 | 2019-10-23 |
| 1437560505 | This Little Light | Durable Medical Equipment & Medical Supplies | 439 Doral Ter, University Park, IL 60484-2712 | 2014-05-12 |
| 1396232633 | Heather Williams | Chore Provider | 1 Thornwood Mall, University Park, IL 60484-2725 | 2018-04-20 |
| 1003205279 | Theresia Fonge | Non-emergency Medical Transport (VAN) | 4790 Hickory Creek Dr, Apt 8, University Park, IL 60484-2740 | 2015-01-12 |
| 1427366764 | Rupel Emmanuel Marshall Jr. | Pharmacist | 437 Brassie Ln, University Park, IL 60484-2775 | 2010-09-21 |
| 1972949261 | Lida Stewart | Developmental Therapist | 430 Brassie Ct, University Park, IL 60484-2777 | 2013-05-14 |
| 1053897736 | Grand Prairie Services | Clinic/Center | 759 Burr Oak Ln, University Park, IL 60484-2865 | 2018-07-16 |
| 1881086999 | Kay-kaymonique Pena | Social Worker | 706 Circle Dr, University Park, IL 60484-2907 | 2015-02-26 |
| 1174862213 | Norman Mays | Private Vehicle | 733 Union Dr, University Park, IL 60484-2918 | 2013-02-09 |
| Find all providers in zip 60484 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073086427 | Catrena Craig | Counselor | 691 Sullivan Ln, University Park, IL 60484-3030 | 2019-01-08 |
| 1679022578 | Danielle Tiley | Counselor | 6302 Queens Chapel Rd, University Park, MD 20782-2130 | 2016-10-03 |
| 1538467071 | Pia P Lipscomb-king | Counselor | 6300 44th Ave, University Park, MD 20782-2122 | 2011-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780602 | Saba Aqel | Counselor | 107 W Van Buren St Ste 215, Chicago, IL 60605-1054 | 2020-11-05 |
| 1124629696 | Audra Murphy | Counselor | 1020 E Ogden Ave Ste 204, Naperville, IL 60563-8610 | 2020-11-02 |
| 1811597412 | Mindy Marie Eastling | Counselor | 27240 Dutton Rd, Beecher, IL 60401-5054 | 2020-11-01 |
| 1306446307 | Oak Point Counseling, Pllc | Counselor | 1207 Mchenry Rd Ste 217b, Buffalo Grove, IL 60089-1371 | 2020-10-28 |
| 1508466061 | Kathrin Simac | Counselor | 900 Royal Heights Rd # 2150, Belleville, IL 62226-5457 | 2020-10-26 |
| 1669071288 | Kristin Smith Warden | Counselor | 566 Cedar St, Winnetka, IL 60093-2338 | 2020-10-24 |
| 1538768155 | Angelicare LLC | Counselor | 6650 N Northwest Hwy Ste 215, Chicago, IL 60631-1363 | 2020-10-23 |
| 1568061612 | Donnie L Winget | Counselor | 536 N Division St, Carterville, IL 62918-1006 | 2020-10-20 |
| 1013516145 | Modern Soul Therapy LLC | Counselor | 2000 N Racine Ave Ste 2160, Chicago, IL 60614-4045 | 2020-10-20 |
| 1861090433 | Ruth Elaine Rayfield | Counselor | 418 North Center Street, Apt# 206, South Elgin, IL 60177 | 2020-10-15 |
| Find all providers with the same taxonomy | ||||
| City | UNIVERSITY PARK |
| Zip Code | 60484 |
Please comment or provide details below to improve the information on DANIEL WALLACE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.