IndividualActive
Ericka Wallace
NPI 1528932506 · Nutritionist · Matteson, IL
Ericka Wallace is a Nutritionist provider in Matteson, IL (NPI 1528932506).
Provider details
- NPI number
- 1528932506
- Entity type
- Individual
- Primary specialty
- NutritionistDietary & Nutritional Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 18343 (IL)
Practice location
Po Box 665
Matteson, IL 60443-0665
Phone: (312) 613-3335
Approximate (ZIP-level) locationGet directions
Mailing address
3935 W 64th Pl
Chicago, IL 60629-4714
Registry dates
- Enumerated
- 2025-10-02
- Last updated
- 2025-10-02
- Certified
- 2025-10-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.