MADISON WALLACE MHP NPI 1003622937

NPI Information

  • NPI: 1003622937
  • Provider Name: MADISON WALLACE, MHP
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 325 ILLINOIS RT 2
    DIXON, IL
    ZIP 61021
  • Phone: (815) 284-6611

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NPI Details

Madison Wallace, MHP is a mental health counselor in Dixon, IL. Madison Wallace, MHP NPI is 1003622937. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

325 ILLINOIS RT 2
DIXON, IL
ZIP 61021-118
Phone: (815) 284-6611

The enumeration date for this NPI number is 12/5/2024 and was last updated on 12/5/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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