Earnest Wallace

Case Manager/Care Coordinator · Blue Island, IL

Individual Active NPI

NPI number 1548658149

Practice location

13136 Western Ave
Blue Island, IL 60406-2423
Phone
(708) 974-5815

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NPI record

NPI
1548658149
Entity type
Individual (Type 1)
Enumeration date
January 5, 2015
Last updated
January 5, 2015
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Case Manager/Care Coordinator Primary 171M00000X — —

About Earnest Wallace

Earnest Wallace is a healthcare provider registered in the NPI registry with the primary taxonomy Case Manager/Care Coordinator (code 171M00000X). The practice location is 13136 Western Ave, Blue Island, IL 60406-2423. The NPI number 1548658149 was assigned on January 5, 2015 and the record was last updated on January 5, 2015.

Frequently asked questions

What is the NPI number of Earnest Wallace?

The NPI number is 1548658149.

What is the phone number of Earnest Wallace?

The phone number listed for the practice location is (708) 974-5815.

Where is Earnest Wallace located?

13136 Western Ave, Blue Island, IL 60406-2423.

What is the taxonomy code for Earnest Wallace?

The primary taxonomy code is 171M00000X – Case Manager/Care Coordinator.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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