Individual
PATRICIA ANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
5949 W RAYMOND ST, INDIANAPOLIS, IN 46241-4348
(317) 247-1579
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31000396A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000355350
ANTHEM ID
IN
05
—
200515660
—
IN
Enumeration date
04/06/2006
Last updated
08/05/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us