Julian Wallis

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

800 Elgin Rd Apt 1316
Evanston, IL 60201-5629

Phone

(312) 273-8704

NPI assigned

Mar 9, 2023

Last updated

Mar 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1063112720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ELGIN RD APT 1316",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602015629",
            "telephone_number": "312-273-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ELGIN RD APT 1316",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602015629",
            "telephone_number": "312-273-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "JULIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvonne D Wallace-Robinson, PTA
• Camilla Wallace, LCSW
• Joseph Eli Wallach, PH.D.
• Luke Wallens
• Benjamin S. Wallis, MD
• Darah Elaine Wallsten, PSYD
• Jennifer Walsh, CRNA
• Matthew Walsh, LSW
• Maureen Elizabeth Walsh, FNP
• Nora Josephine Walsh, LCSW

• Student in an Organized Health Care Education/Training Program in Evanston, IL
• Providers in Evanston, IL by specialty
• Student in an Organized Health Care Education/Training Program in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.