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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ELIZABETH NICOLE WALLIS MD
NPI 1821551334
Pediatrics in Bloomington, IL

Active since April 11, 2019PECOS Enrolled
200 W MONROE ST STE 302, BLOOMINGTON, IL 61701(309) 204-6766 Get Directions Write a Review

NPPES record last updated: August 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 3, 2026, Jul 29, 2026, Apr 11, 2023 and 1 more (4 updates tracked since 2019).

About Elizabeth Nicole Wallis Md NPPES

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

ELIZABETH NICOLE WALLIS MD (NPI 1821551334) is an individual pediatrics provider in Bloomington, Illinois, licensed in Louisiana (331615) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821551334
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameELIZABETH NICOLE WALLISCredential: MD
Location Address200 W MONROE ST STE 302Bloomington, IL 61701-3997
Mailing Address200 W Monroe St Ste 302Bloomington, IL 61701-3997 · (309) 204-6766
Phone(309) 204-6766
Sole ProprietorNo
Enumeration DateApril 11, 2019
Last NPPES UpdateAugust 3, 20264 updates tracked since enumeration
NPPES CertifiedAugust 3, 2026
✔ NPI 1821551334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in LA · 331615✔ Licensed in IL · 036.176418
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
200 W MONROE ST STE 302, Bloomington, IL 61701
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elizabeth Nicole Wallis Md 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 61701 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
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

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 Elizabeth Wallis's NPI number?

The NPI number for Elizabeth Wallis is 1821551334. It was assigned to this individual provider in the NPPES registry on April 11, 2019.

Where is Elizabeth Wallis located?

Elizabeth Wallis practices at 200 W Monroe St Ste 302, Bloomington, IL 61701. The listed phone number is (309) 204-6766.

What is Elizabeth Wallis's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Elizabeth Wallis enrolled in Medicare?

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

What insurance does Elizabeth Wallis accept?

Health plans from AmeriHealth Caritas Next list Elizabeth Wallis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Elizabeth Wallis was last updated on August 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days 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.