Active NPI
Trinity Walls, NP
- Nurse Practitioner
- Chicago, IL
National Provider Identifier
1053970558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 277.002315
- Practice address
- 111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597 - Phone
- (888) 731-8994
- NPI assigned
- Jun 7, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 209.018941 | IL | |
| Women's Health Nurse Practitioner | 363LW0102X | 277.002315 | IL | |
| Nurse Practitioner | 363L00000X | 277.002315 | IL | Primary |
Addresses
Primary practice location
111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597
Mailing address
PO Box 1014
Matteson, IL 60443-4014
Other practice location 1
139 Centre St Ph 120
New York, NY 10013-4559
Phone (888) 731-8994
Other practice location 2
111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone (888) 731-8994
Other names 1
- Ms. Trinity Clark
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 95.11 of 100
- Quality
- 74.7
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 85.45
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277.002315 | IL | MD | Nurse Practitioner |
| 209.018941 | IL | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook County | Current | Accepting new patients | |
| Cook County | Current | Accepting new patients | |
| Cook County | Current | Accepting new patients | |
| Integrative Womens Care PC | Past | Accepting new patients | |
| Midwest Illinois Six Medical Group, PLLC | Past | Accepting new patients |
Locations
500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000
1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100
Interoperability endpoints
- trinity.walls.1@27069.direct.athenahealth.com
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1588612832
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1821385170
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1831219450
-
- Obstetrics & Gynecology Physician
- Palo Alto, CA
- NPI 1972266732
-
- Primary Care Clinic/Center
- Houston, TX
- NPI 1295493047
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736812800000",
"number": "1053970558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1014",
"city": "MATTESON",
"state": "IL",
"postal_code": "604434014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 W JACKSON BLVD STE 1700",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606043597",
"telephone_number": "888-731-8994"
}
],
"practiceLocations": [
{
"address_1": "139 Centre St Ph 120",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100134559",
"country_code": "US",
"telephone_number": "888-731-8994",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "111 N Orange Ave Ste 800",
"address_purpose": "LOCATION",
"city": "Orlando",
"state": "FL",
"postal_code": "328012381",
"country_code": "US",
"telephone_number": "888-731-8994",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALLS",
"first_name": "TRINITY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-07",
"last_updated": "2025-01-14",
"certification_date": "2025-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "IL",
"license": "209.018941",
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "IL",
"license": "277.002315",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "277.002315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TRINITY",
"last_name": "CLARK",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.