Diane Elizabeth Wallis, MD | |
3825 Highland Ave, Suite 400, Downers Grove, IL 60515-1552 | |
(630) 719-4799 | |
Not Available |
Full Name | Diane Elizabeth Wallis |
---|---|
Gender | Female |
Speciality | Internal Medicine - Cardiovascular Disease |
Location | 3825 Highland Ave, Downers Grove, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659323574 | NPI | - | NPPES |
036061857 | Medicaid | IL | |
060043700 | Other | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RC0000X | Internal Medicine - Cardiovascular Disease | 036061857 (Illinois) | Primary |
Entity Name | Advocate Health And Hospitals Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1700824455 PECOS PAC ID: 7810800935 Enrollment ID: O20031106000064 |
Entity Name | Central Dupage Hospital Association |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003864810 PECOS PAC ID: 0941108666 Enrollment ID: O20031231000723 |
Entity Name | Edward Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013969013 PECOS PAC ID: 0042108110 Enrollment ID: O20040309001279 |
Mailing Address | Practice Location Address |
---|---|
Diane Elizabeth Wallis, MD 1919 S Highland Ave, Suite B202 Attn Jan Lewis, Lombard, IL 60148-6153 Ph: (630) 268-1102 | Diane Elizabeth Wallis, MD 3825 Highland Ave, Suite 400, Downers Grove, IL 60515-1552 Ph: (630) 719-4799 |
Hajira Younas Khan, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 5207 Main St, Downers Grove, IL 60515 Phone: 630-435-9888 Fax: 630-963-1524 | |
Peter Michael Kerwin, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 3825 Highland Ave, Tower 2 Suite 400, Downers Grove, IL 60515 Phone: 630-719-4799 | |
Stephen Michael Rowley, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 3825 Highland Ave, Tower 2 Suite 400, Downers Grove, IL 60515 Phone: 630-719-4799 | |
Dr. Anil Vamsi Doppalapudi, M.D Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 3825 Highland Ave Ste 3d, Downers Grove, IL 60515 Phone: 630-964-7006 Fax: 630-964-7082 | |
Mark J. Tatara, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 6840 Main St Ste 200, Downers Grove, IL 60516 Phone: 630-869-5382 Fax: 630-869-5383 | |
Dr. Weiser Eguia Cordero, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 5207 Main St, Downers Grove, IL 60515 Phone: 630-435-9888 Fax: 630-963-1524 | |
Iva Minga, M.D. Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 3825 Highland Ave Fl Tower24, Downers Grove, IL 60515 Phone: 630-719-4799 Fax: 630-963-7420 |