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Tiara Wallace
NPI 1427927037 · on the registry since 2025
Practice
- Address
- 2363 63rd St Ste 103
Woodridge, IL 60517 - Phone
- (630) 856-8700
- Organisation at this address
- Adventist Midwest Health
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 20
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-11-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois