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DOUGLAS M WALLEN
NPI 1407010176
Dentist - General Practice in Champaign, IL

Active since July 11, 2008PECOS Enrolled
2502 GALEN DR, SUITE 103, CHAMPAIGN, IL 61821(217) 366-0050 Get Directions Write a Review

NPPES record last updated: July 11, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Douglas M Wallen NPPES

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

DOUGLAS M WALLEN (NPI 1407010176) is an individual general practice provider in Champaign, Illinois, licensed in Illinois (019020653) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407010176
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDOUGLAS M WALLEN
Location Address2502 GALEN DR, SUITE 103Champaign, IL 61821-7045
Mailing Address2502 Galen Dr, Suite 103Champaign, IL 61821-7045 · (217) 366-0050
Phone(217) 366-0050
Sole ProprietorYes
Enumeration DateJuly 11, 2008
✔ NPI 1407010176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in IL · 019020653
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
2502 GALEN DR, Champaign, IL 61821
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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)

Douglas M Wallen 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 61821 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
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Douglas Wallen's NPI number?

The NPI number for Douglas Wallen is 1407010176. It was assigned to this individual provider in the NPPES registry on July 11, 2008.

Where is Douglas Wallen located?

Douglas Wallen practices at 2502 Galen Dr Suite 103, Champaign, IL 61821. The listed phone number is (217) 366-0050.

What is Douglas Wallen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Douglas Wallen enrolled in Medicare?

Yes. Douglas Wallen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Douglas Wallen was last updated on July 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.