KENDALL E WALLACE APRN
NPI 1003391061
Nurse Practitioner - Family in Urbana, IL

Q: What is Kendall Wallace's NPI number?

The NPI number for Kendall Wallace is 1003391061. It was assigned to this individual provider in the NPPES registry on September 26, 2018. The provider is also known as Kendall E Young.

Q: What is Kendall Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kendall Wallace was last updated on April 4, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 26, 2018PECOS EnrolledAccepts Medicare Assignment

611 W PARK ST, URBANA, IL 61801(217) 383-3311 Get Directions Write a Review

NPPES record last updated: April 4, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 4, 2024, Feb 23, 2022, Sep 26, 2018 (3 updates tracked since 2018).

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About Kendall E Wallace Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENDALL E WALLACE APRN (NPI 1003391061) is an individual family provider in Urbana, Illinois, licensed in Illinois (209017908) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS, is affiliated with Saint Francis Medical Center, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1003391061

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKENDALL E WALLACECredential: APRN

Location Address611 W PARK STUrbana, IL 61801-2529

Mailing Address611 W Park StUrbana, IL 61801-2501

Phone(217) 383-3311

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateSeptember 26, 2018

Last NPPES UpdateApril 4, 20243 updates tracked since enumeration

NPPES CertifiedApril 4, 2024

✔ NPI 1003391061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IL · 209017908

611 W PARK ST, Urbana, IL 61801

Open in Google Maps ↗

Other Names 1

Former Name (1)Kendall E Young

Other Identifiers 1

Other041412378IL · Rn License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kendall E Wallace Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305180266

PECOS Enrollment IDI20181204000097

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140067

Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County

Emergency services Birthing friendly

Decatur Memorial Hospital

Acute Care Hospitals · Decatur, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140135

Location2300 North Edward StreetDecatur, IL 62526 · Macon County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61801 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. UDAY BHASKAR KANAKADANDI MD

Internal Medicine (Interventional Cardiology)

611 W PARK ST, HVI
URBANA, IL 61801

Champaign County (217) 383-3110

DR. VIKAS DESAI MD

Urology