Individual provider Active NPI

James A Wallace

  • Medical Oncology Physician
  • Chicago, IL
National Provider Identifier
1669687307
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
036113259 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone
(888) 824-0200
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 036113259 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1443

Mailing address

150 Harvester Dr
Suite 300
Burr Ridge, IL 60527-5919

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwallacemd11502@uchospital.direct-ci.com University of Chicago Physicians Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080626000710 IL Practitioner - Medical OncologyPractitioner - Hematology/OncologyPractitioner - Geriatric Medicine 2062476591 Reassigns benefits to 3 organizations
I20080714000523 IN Practitioner - Medical OncologyPractitioner - Geriatric Medicine 2062476591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Geriatric Medicine, Hematology/Oncology
Education
University of Vermont College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ucm Medical Group Sub LLCGroup PAC ID 4688635337, 101 clinicians

Practice addresses (Care Compare)

1 Ingalls Dr
Harvey, IL 60426-3558
Phone (708) 333-2300

1600 Torrence Ave
Calumet City, IL 60409-5430
Phone (708) 647-7565

19550 Governors Hwy
Flossmoor, IL 60422-2147
Phone (708) 342-3000

6701 159TH St
Suite 1
Tinley Park, IL 60477-1758
Phone (708) 798-9475

71 W 156TH St
Harvey, IL 60426-4265

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036113259ILMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Medical Center Inc Current Accepting new patients
The University of Chicago Medical Center CurrentSince Feb 1, 2010 Accepting new patients
Ucm Medical Group Sub, LLC Geriatric Medicine CurrentSince Mar 1, 2013 Accepting new patients
The University of Chicago Medical Center CurrentSince Feb 1, 2010 Accepting new patients
University of Chicago CurrentSince Oct 7, 2018 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

27702 Network Pl
Chicago, IL 60673

19550 Governors Hwy
#3300
Flossmoor, IL 60422

19550 Governors Hwy
Ste 3500
Flossmoor, IL 60422
Phone (708) 922-9170

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

71 W 156th St
Ste 401
Harvey, IL 60426
Phone (708) 339-4800

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

6701 159th St
Ste 1
Tinley Park, IL 60477
Phone (708) 444-2226

10855 Virginia St
Ste 2200
Crown Point, IN 46307
Phone (219) 407-5540

10855 Virginia St
Ste 2100
Crown Point, IN 46307
Phone (219) 407-5540

1500 S Lake Park Ave
Ste 109
Hobart, IN 46342
Phone (219) 942-0551

801 MacArthur Blvd
Ste 401
Munster, IN 46321
Phone (219) 836-2860

1946 45th St
Munster, IN 46321
Phone (219) 703-2420

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1669687307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR",
            "address_2": "SUITE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "888-824-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JAMES",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "036113259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwallacemd11502@uchospital.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "University of Chicago Physicians Group",
            "address_1": "5841 S Maryland Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606371443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.