IndividualActive
Keith Wallace, L.C.S.W.
NPI 1104971712 · Social Worker · Chicago, IL
Keith Wallace, L.C.S.W. is a Social Worker provider in Chicago, IL (NPI 1104971712).
Provider details
- NPI number
- 1104971712
- Entity type
- Individual
- Primary specialty
- Social WorkerBehavioral Health & Social Service Providers
- Credential
- L.C.S.W.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 149-012034 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Children'S Memorial Hospital
2300 Children'S Plaza, Box 10
Chicago, IL 60614
Phone: (773) 975-8604
Approximate (ZIP-level) locationGet directions
Mailing address
Children'S Memorial Hospital
Chicago, IL 60614
Registry dates
- Enumerated
- 2007-01-24
- Last updated
- 2008-10-27
Frequently asked questions
- What is Keith Wallace's NPI number?
- Keith Wallace's National Provider Identifier (NPI) is 1104971712, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Keith Wallace's specialty?
- Keith Wallace is listed in the NPPES registry with a primary specialty of Social Worker (Behavioral Health & Social Service Providers).
- Where is Keith Wallace located?
- Keith Wallace's practice location on file with NPPES is Children'S Memorial Hospital, Chicago, IL 60614.
- What is Keith Wallace's phone number?
- The practice phone number listed in the NPPES registry for Keith Wallace is (773) 975-8604.
- Is Keith Wallace's NPI active?
- Yes — Keith Wallace's NPI (1104971712) is active in the NPPES registry as of the last update on 2008-10-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.