Megan Ann Wallace, M.A., CCC-SLP/LD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.009659 Issued in IL

Practice address

1000 W 15TH St
Unit 224
Chicago, IL 60608-1882

Phone

(773) 209-9628

NPI assigned

Oct 9, 2009

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1972838878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W 15TH ST",
            "address_2": "UNIT 224",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081882",
            "telephone_number": "773-209-9628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W 15TH ST",
            "address_2": "UNIT 224",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081882",
            "telephone_number": "773-209-9628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MEGAN",
        "middle_name": "ANN",
        "credential": "M.A., CCC-SLP/LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-09",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.009659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Gensler Wallace, DNP
• Kathleen Wallace
• Keith V. Wallace, L.C.S.W.
• Kevin R Wallace, DMD
• Lawanda Wallace
• Nicole Wallace
• Robert J Wallace, LAC, LMT
• Sara Wallace
• Sara J Wallace
• Susan R Wallace

• Speech-Language Pathologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.