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JULIAN WALLIS
NPI 1063112720
Student in an Organized Health Care Education/Training Program in Evanston, IL

Active since March 09, 2023PECOS Enrolled
800 ELGIN RD APT 1316, EVANSTON, IL 60201(312) 273-8704 Get Directions Write a Review

NPPES record last updated: March 9, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Julian Wallis NPPES

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

JULIAN WALLIS (NPI 1063112720) is an individual student in an organized health care education/training program in Evanston, Illinois and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063112720
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJULIAN WALLIS
Location Address800 ELGIN RD APT 1316Evanston, IL 60201-5629
Mailing Address800 Elgin Rd Apt 1316Evanston, IL 60201-5629 · (312) 273-8704
Phone(312) 273-8704
Sole ProprietorYes
Enumeration DateMarch 9, 2023
NPPES CertifiedMarch 2, 2023
✔ NPI 1063112720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
800 ELGIN RD APT 1316, Evanston, IL 60201
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Julian Wallis is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Julian Wallis's NPI number?

The NPI number for Julian Wallis is 1063112720. It was assigned to this individual provider in the NPPES registry on March 9, 2023.

Where is Julian Wallis located?

Julian Wallis practices at 800 Elgin Rd Apt 1316, Evanston, IL 60201. The listed phone number is (312) 273-8704.

What is Julian Wallis's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Julian Wallis enrolled in Medicare?

Yes. Julian Wallis is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Julian Wallis was last updated on March 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.