Individual provider · Type 1 NPI

Lawanda Wallace

Private Vehicle · Chicago, IL

NPI number 1154788875 Active

Practice location

11559 S Oakley Ave
Chicago, IL 60643-4721

Call (773) 391-6689 Map

Specialties and licenses

TaxonomyCodeLicense
Private Vehicle Primary 347C00000XW42053371706 (IL)

Private Vehicle: An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.

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About NPI 1154788875

Lawanda Wallace's National Provider Identifier is 1154788875, issued on Jan 26, 2016. The primary taxonomy on file is Private Vehicle (347C00000X), and the practice location is in Chicago, IL. The record was last updated on Sep 29, 2026.