Individual provider Active NPI

Andrea Eve Wallach, LCSW MSW

  • Social Worker
  • Arlington Heights, IL
National Provider Identifier
1033193545
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
115 S Wilke Rd
206 D
Arlington Heights, IL 60005-1532
Phone
(847) 256-6426
Fax
(847) 967-0929
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X IL Primary

Addresses

Primary practice location

115 S Wilke Rd
206 D
Arlington Heights, IL 60005-1532

Mailing address

208 Charles PL
Wilmette, IL 60091-3008
Phone (847) 246-6426

Other identifiers 1

IdentifierTypeStateIssuer
0001673683OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149001755ILMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1033193545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 CHARLES PL",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600913008",
            "telephone_number": "847-246-6426",
            "fax_number": "847-256-6154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S WILKE RD",
            "address_2": "206 D",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051532",
            "telephone_number": "847-256-6426",
            "fax_number": "847-967-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "ANDREA",
        "middle_name": "EVE",
        "name_prefix": "Mrs.",
        "credential": "LCSW MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001673683",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.