Beth Ann Wallace, M.S.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

147000988 Issued in IL

Practice address

4127 Progress Blvd
Peru, IL 61354-1112

Phone

(815) 223-3201

Fax

(815) 223-3202

NPI assigned

Oct 23, 2012

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

Qualified Audiologist

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Wallace Center for Hearing, LLCGroup PAC ID 6709276991, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Wallace Center for Hearing, LLC

  • Audiologist
  • Peru, IL
  • NPI 1700558467
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1871846204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4127 PROGRESS BLVD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541112",
            "telephone_number": "815-866-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4127 PROGRESS BLVD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541112",
            "telephone_number": "815-223-3201",
            "fax_number": "815-223-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "BETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-23",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147000988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co.
• Walgreens
• Michele Walker
• Wallace Center for Hearing, LLC
• Walmart Inc.
• Wellness and Recovery With Maitri, Inc. NFP
• Christopher A Westphal, CRNA
• Shenyka Micole Wheatly, PA-C
• Gina Wiesbrock, ATC

• Audiologist in Peru, IL
• Providers in Peru, IL by specialty
• Audiologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.