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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

HEIDI ALLISON WILKEN WALLACE, LCSW

Active Sole Proprietor

HEIDI ALLISON WILKEN WALLACE, LCSW is a Clinical Social Worker healthcare provider located in WALNUT, Illinois. NPI 1528107471 is currently active in the NPPES registry. Verify at CMS.

Clinical Social Worker · WALNUT, IL

Registration Details

NPI Number
1528107471
Provider Type
Individual
Gender
Female
NPI Issued
Feb 6, 2007 (19.490857365589 yrs)
Last Updated
Nov 19, 2012
Licenses
149012947 (IL)
HW49060306P (IL)
Sole Proprietor
Yes

Practice Information

Address
27566 1375 EAST ST
WALNUT, IL, 613769528
Browse IL providers · Browse ZIP 61376
Phone
8153837277
Fax
8153792184
Primary Specialty
Clinical Social Worker
1041C0700X
Additional Specialty
Developmental Therapist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.