MS. NATHASA WALLACE FNP
NPI 1326420530
Nurse Practitioner - Family in Harvey, IL

Q: What is Nathasa Wallace's NPI number?

The NPI number for Nathasa Wallace is 1326420530. It was assigned to this individual provider in the NPPES registry on June 24, 2015.

Q: What is Nathasa 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 Nathasa Wallace was last updated on July 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.

Active since June 24, 2015PECOS Enrolled

31 W 155TH ST, HARVEY, IL 60426(708) 596-5177(708) 596-5518 Get Directions Write a Review

NPPES record last updated: July 16, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 18, 2024, Jun 10, 2022, Jul 8, 2021 (3 updates tracked since 2021).

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About Ms. Nathasa Wallace Fnp NPPES

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

MS. NATHASA WALLACE FNP (NPI 1326420530) is an individual family provider in Harvey, Illinois, licensed in Illinois (209.012383) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Chicago.

NPPES Registry Identity

NPI1326420530

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMS. NATHASA WALLACECredential: FNP

Location Address31 W 155TH STHarvey, IL 60426-3556

Mailing Address31 W 155th StHarvey, IL 60426-3556 · (708) 596-5177 · Fax (708) 596-5518

Phone(708) 596-5177

Fax(708) 596-5518

Sole ProprietorYes

Enumeration DateJune 24, 2015

Last NPPES UpdateJuly 16, 20253 updates tracked since enumeration

NPPES CertifiedJuly 16, 2025

✔ NPI 1326420530 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 · 209.012383

31 W 155TH ST, Harvey, IL 60426

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Secondary Practice Location 1

Location 15906 N Milwaukee AveChicago, IL 60646-5420 · Phone (773) 774-7300

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Nathasa Wallace Fnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60426 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

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

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.

MISS MAIRA OCHOA APN

Nurse Practitioner (Family)