Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ERICKA WALLACE
ActiveERICKA WALLACE is a Nutritionist healthcare provider located in MATTESON, Illinois. NPI 1528932506 is currently active in the NPPES registry. Verify at CMS.
Nutritionist · MATTESON, IL
Registration Details
- NPI Number
- 1528932506
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 2, 2025 (0.90095298898478 yrs)
- Last Updated
- Oct 2, 2025
- License
-
18343 (IL)
Practice Information
- Address
-
PO BOX 665MATTESON, IL, 604430665Browse IL providers · Browse ZIP 60443
- Phone
- 3126133335
- Primary Specialty
-
Nutritionist
133N00000X
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.