Shelby Wall, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013468 Issued in IL

Practice address

424 S Euclid Ave
Oak Park, IL 60302-3928

Phone

(319) 480-7085

NPI assigned

Nov 16, 2019

Last updated

Nov 16, 2019By the provider in NPPES

Sex

Female

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 IL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Evolve Chiropractic Woodstock PLLCGroup PAC ID 4183975477, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Evolve Chiropractic Woodstock PLLC

  • Chiropractor
  • Woodstock, IL
  • NPI 1063908218
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1573862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573862400000",
    "number": "1194360867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 S EUCLID AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603023928",
            "telephone_number": "319-480-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 S EUCLID AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603023928",
            "telephone_number": "319-480-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "SHELBY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-16",
        "last_updated": "2019-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #11760)
• Jodi Julia Walker, CCC-SLP
• Jordan Walker
• Karen Marie Walker, M.D.
• Kelsey Walker
• Sierra Waller
• Meredith Walsh-Beteta, LCMT
• Mathew Walsh, MD
• Kimberly Walton, L.C.S.W.
• Wanderlust Therapy Chicago, LLC

• Chiropractor in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.