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SUSAN R WALLACE
NPI 1043958176
Counselor - Mental Health in Chicago, IL

Active since May 27, 2022
2715 N CENTRAL AVE, CHICAGO, IL 60639(773) 360-1389 Get Directions Write a Review

NPPES record last updated: May 27, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Susan R Wallace NPPES

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

SUSAN R WALLACE (NPI 1043958176) is an individual mental health provider in Chicago, Illinois and active in the NPI registry since May 2022.

NPPES Registry Identity

NPI1043958176
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSUSAN R WALLACE
Location Address2715 N CENTRAL AVEChicago, IL 60639-1351
Mailing Address86 E 13th StChicago Heights, IL 60411-2761 · (708) 466-9457
Phone(773) 360-1389
Sole ProprietorYes
Enumeration DateMay 27, 2022
NPPES CertifiedMay 27, 2022
✔ NPI 1043958176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
2715 N CENTRAL AVE, Chicago, IL 60639
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Other Providers at the Same Location NPPES 17

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

BRITTANY KING MSW, LSW
Counselor
2715 N CENTRAL AVE
CHICAGO, IL 60639
Cook County (773) 632-8329
SCOTT MICHAEL HERMAN LCSW
Social Worker
2715 N CENTRAL AVE
CHICAGO, IL 60639
Cook County (773) 360-1389
CENTRAL MEDICAL SPECIALISTS LLC
Orthopaedic Surgery
2715 N CENTRAL AVE
CHICAGO, IL 60639
Cook County (312) 326-6100
MS. LORIE ESTHER FUENTES
Counselor
2715 N CENTRAL AVE
CHICAGO, IL 60639
Cook County (773) 360-1389
TANYA A JOHNSON-RAMEY
Counselor (Mental Health)
2715 N CENTRAL AVE
CHICAGO, IL 60639
Cook County (773) 360-1389
JOVANA GOMEZ
Counselor (Mental Health)
2715 N CENTRAL AVE
CHICAGO, IL 60639
Cook County (773) 360-1389
AFSHAN MAHMOOOD LSW
Social Worker
2715 N CENTRAL AVE
CHICAGO, IL 60639
Cook County (773) 360-1389
DR. WARREN BRADEN SR. ED.D.
Marriage & Family Therapist
2715 N CENTRAL AVE
CHICAGO, IL 60639
Cook County (773) 360-1389

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan Wallace's NPI number?

The NPI number for Susan Wallace is 1043958176. It was assigned to this individual provider in the NPPES registry on May 27, 2022.

Where is Susan Wallace located?

Susan Wallace practices at 2715 N Central Ave, Chicago, IL 60639. The listed phone number is (773) 360-1389.

What is Susan Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Susan Wallace was last updated on May 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.