IndividualActive
Janice Wallace, MA, CCC-SLP/L
NPI 1710241633 · Speech-Language Pathologist · Eddyville, IL
Provider details
- NPI number
- 1710241633
- Entity type
- Individual
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Credential
- MA, CCC-SLP/L
- Sex
- Female
- Sole proprietor
- No
- License
- 146008090 (IL)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 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
74 Old Home Rd
Eddyville, IL 62928-9734
Phone: (618) 672-4300
Street-level locationGet directions
Mailing address
74 Old Home Rd
Eddyville, IL 62928-9734
Registry dates
- Enumerated
- 2012-06-25
- Last updated
- 2012-06-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.