ANDREW R WALL LCPC
NPI 1376899799
Counselor - Professional in Chicago, IL
About Andrew R Wall Lcpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREW R WALL LCPC (NPI 1376899799) is an individual professional provider in Chicago, Illinois, licensed in Illinois (180008228) and active in the NPI registry since August 2012. He has opted out of Medicare through January 23, 2028.
NPPES Registry Identity
Specialties & Licenses 4
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Andrew R Wall Lcpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 23, 2024 through January 23, 2028.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHICAGO, IL 60647
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 Andrew Wall's NPI number?
The NPI number for Andrew Wall is 1376899799. It was assigned to this individual provider in the NPPES registry on August 3, 2012.
Where is Andrew Wall located?
Andrew Wall practices at 2302 W North Ave Unit 1E, Chicago, IL 60647. The listed phone number is (773) 551-7204.
What is Andrew Wall's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Andrew Wall enrolled in Medicare?
No. Andrew Wall has opted out of Medicare through January 23, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Andrew Wall was last updated on October 2, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Andrew R Wall, LCPC · NPI 1376899799
Professional provider in Chicago, Illinois. Individual provider, active in the CMS NPPES registry since August 3, 2012.
## Identity
- **NPI:** 1376899799 (Entity type: Individual)
- **Enumerated:** August 3, 2012
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 180008228 (Illinois)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2302 W NORTH AVE, UNIT 1E, Chicago, IL 60647-6260
- **Phone:** (773) 551-7204 · **Fax:** (773) 342-4200
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through January 23, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** October 2, 2014
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Source: [NPI Profile](https://npiprofile.com/npi/1376899799) · Data from the CMS NPPES public registry.