Alexander M Wallin, PTA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

160009955 Issued in IL

Practice address

1513 Dekalb Ave
Sycamore, IL 60178-2703

Phone

(630) 933-1500

NPI assigned

Oct 2, 2023

Last updated

Oct 2, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Midwest Orthopaedic Institute P C

  • Orthopaedic Surgery Physician
  • Sycamore, IL
  • NPI 1013976927

  Physical Therapist

  NPD
• Kishwaukee Community Health Services Center

  dba Kishwaukee Community Hospital

  • Psychiatric Hospital Unit
  • Dekalb, IL
  • NPI 1902079973
  NPD (past)

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1275313991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 DEKALB AVE",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601782703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 DEKALB AVE",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601782703",
            "telephone_number": "630-933-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "ALEXANDER",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "160009955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latoya Walker, MSED
• Michael Walker, ATC
• Michelle Walker, LSW
• Rebecca Walker, ATC
• Jennifer K Wallace, DNP, APRN, FNP-BC
• Cassady May Wank, PSY.D.
• Micheal D Wank, PA-C
• Hanna Weber, APRN, CNP
• Christopher Wayne Weller, P.T.
• Wells and Associates Wellness Center

• Physical Therapist in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.