Lizabeth Wallace
NPI 1417019084 · Nurse Practitioner · Peoria, IL
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lizabeth Wallace is a Nurse Practitioner provider in Peoria, IL (NPI 1417019084).
Provider details
- NPI number
- 1417019084
- Entity type
- Individual
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 0411285741-209004409 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
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
Mailing address
Registry dates
- Enumerated
- 2006-12-13
- Last updated
- 2009-04-20
Frequently asked questions
- What is Lizabeth Wallace's NPI number?
- Lizabeth Wallace's National Provider Identifier (NPI) is 1417019084, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Lizabeth Wallace's specialty?
- Lizabeth Wallace is listed in the NPPES registry with a primary specialty of Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Lizabeth Wallace located?
- Lizabeth Wallace's practice location on file with NPPES is 420 Ne Glen Oak Ave, Peoria, IL 61603-3105.
- What is Lizabeth Wallace's phone number?
- The practice phone number listed in the NPPES registry for Lizabeth Wallace is (309) 655-2343.
- Does Lizabeth Wallace accept Medicare?
- Lizabeth Wallace is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Lizabeth Wallace's NPI active?
- Yes — Lizabeth Wallace's NPI (1417019084) is active in the NPPES registry as of the last update on 2009-04-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.