Joseph Eli Wallach, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007942 Issued in IL

Practice address

2530 Crawford Ave
Suite 304
Evanston, IL 60201-4970

Phone

(773) 852-2400

Fax

(847) 869-8116

NPI assigned

Aug 3, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Dr Joseph Wallach PHD LLC

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1861758583

  Cognitive & Behavioral

  NPD (past) Authorized official

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1336453265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2741 W GREENLEAF AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606453013",
            "telephone_number": "773-852-2400",
            "fax_number": "773-856-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE",
            "address_2": "SUITE 304",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014970",
            "telephone_number": "773-852-2400",
            "fax_number": "847-869-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "JOSEPH",
        "middle_name": "ELI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-03",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IL",
            "license": "071007942",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007942",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "IL",
            "license": "071007942",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronnie S Walker, LCPC
• Allison Wall, RD LDN
• Julia Wall, LCSW
• Yvonne D Wallace-Robinson, PTA
• Camilla Wallace, LCSW
• Luke Wallens
• Benjamin S. Wallis, MD
• Julian Wallis
• Darah Elaine Wallsten, PSYD
• Jennifer Walsh, CRNA

• Clinical Psychologist in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.