Camilla Wallace, LCSW in Evanston, IL - Medicare Clinical Social Worker Provider

Camilla Wallace, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Evanston, Illinois. She graduated from medical school in 2006 and has 18 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Extended Care Specialists, Inc and her current practice location is 1007 Church St, Suite 302, Evanston, Illinois. You can reach out to her office (for appointments etc.) via phone at (847) 492-1938.

Camilla Wallace is licensed to practice in Illinois (license number 149.013306) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1851572606.

Contact Information

	Camilla Wallace, LCSW
	1007 Church St, Suite 302, Evanston, IL 60201-3624
	(847) 492-1938
	(847) 423-5670

Map and Direction

Healthcare Provider's Profile

Full Name	Camilla Wallace
Gender	Female
Speciality	Clinical Social Worker
Experience	18 Years
Location	1007 Church St, Evanston, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Camilla Wallace graduated from medical school in 2006

NPI Data:

NPI Number: 1851572606
Provider Enumeration Date: 11/21/2007
Last Update Date: 09/16/2013

Medicare PECOS Information:

PECOS PAC ID: 6901202050
Enrollment ID: I20210915000893

Medical Identifiers

Medical identifiers for Camilla Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1851572606	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	149.013306 (Illinois)	Primary
1041C0700X	Social Worker - Clinical	6801093324 (Michigan)	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Extended Care Specialists, Inc	2466407713	195

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Camilla Wallace allows following entities to bill medicare on her behalf.

Entity Name	Extended Care Specialists, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134146079 PECOS PAC ID: 2466407713 Enrollment ID: O20050318000726

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Camilla Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Camilla Wallace, LCSW 1007 Church St, Suite 302, Evanston, IL 60201-3624 Ph: () -	Camilla Wallace, LCSW 1007 Church St, Suite 302, Evanston, IL 60201-3624 Ph: (847) 492-1938

Reviews and Comments

Social Worker in Evanston, IL

Tabitha Ledbetter, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 355 Ridge Ave Fl 2, Evanston, IL 60202 Phone: 847-316-6262 Fax: 847-316-2214
Kathleen Ann Valadez, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 355 Ridge Ave Fl 2, Evanston, IL 60202 Phone: 847-316-3703
Kathleen A. Bogie, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2143 Lincolnwood Dr, Evanston, IL 60201 Phone: 224-392-5467
Gabrielle Celia Stern, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2530 Crawford Ave Ste 207, Evanston, IL 60201 Phone: 847-732-5305
Susan Burkhardt, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1005 Mulford St, Evanston, IL 60202 Phone: 847-328-8207
Ellen Kenemore, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 708 Church St, Suite 227, Evanston, IL 60201 Phone: 847-491-0080 Fax: 847-251-1266
Nora Josephine Walsh, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 636 Church St Ste 507, Evanston, IL 60201 Phone: 847-409-6288

Camilla Wallace, LCSW - Medicare Clinical Social Worker in Evanston, IL