Debra Wallace, LMFT is a
Marriage & Family Therapist based in Island Lake, Illinois. Debra Wallace is licensed to practice in Illinois (license number 166000901) and her current practice location is
27979 N Converse Rd, Island Lake, Illinois. She can be reached at her office (for appointments etc.) via phone at
(847) 850-9444.
NPI number for Debra Wallace is 1598005019 and her current mailing address is 39469 N Shore Dr, Spring Grove, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1598005019.
Healthcare Provider's Profile
Full Name | Debra Wallace |
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Gender | Female |
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Speciality | Marriage & Family Therapist |
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Location | 27979 N Converse Rd, Island Lake, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1598005019
- Provider Enumeration Date: 02/20/2013
- Last Update Date: 02/20/2013
Medical Identifiers
Medical identifiers for Debra Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1598005019 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
106H00000X | Marriage & Family Therapist | 166000901 (Illinois) | Primary |
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. Debra Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Debra Wallace, LMFT 39469 N Shore Dr, Spring Grove, IL 60081-9170 Ph: (847) 587-0475 | Debra Wallace, LMFT 27979 N Converse Rd, Island Lake, IL 60042-8103 Ph: (847) 850-9444 |
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