DIANE ELIZABETH WALLIS MD NPI 1659323574

NPI Information

  • NPI: 1659323574
  • Provider Name: DIANE ELIZABETH WALLIS, MD
  • Classification: Internal Medicine - 207RC0000X
  • Specialization: Cardiovascular Disease
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3825 HIGHLAND AVE
    SUITE 400
    DOWNERS GROVE, IL
    ZIP 60515
  • Phone: (630) 719-4799

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NPI Details

Diane Elizabeth Wallis, MD is a cardiovascular disease internal medicine in Downers Grove, IL. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Diane Elizabeth Wallis, MD NPI is 1659323574. 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:

3825 HIGHLAND AVE
SUITE 400
DOWNERS GROVE, IL
ZIP 60515-552
Phone: (630) 719-4799

The NPI 1659323574 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/17/2006 and was last updated on 11/29/2016.

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
1207RC0000XInternal MedicineCardiovascular Disease036061857ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D15042MEDICARE UPIN
2036061857MEDICAIDILLINOIS
3060043700OTHERRAILROAD MEDICARE
4724252MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

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

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