Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ericka Wallace

Individual provider Nutritionist · NPI 1528932506

Ericka Wallace is a Nutritionist in Matteson, Illinois. Licensed in Illinois. Registered with an NPI since 2025.

Licensed in
IL
In the registry since
2025
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Practice location PO Box

The provider listed a PO Box rather than a street location, so this is not a walk-in address.

PO Box 665
Matteson, IL 60443-0665
Phone: (312) 613-3335
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nutritionist (primary) Taxonomy 133N00000X · Licence 18343 (IL)

Record details

NPI number1528932506
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 2, 2025
Last updated in NPPESOctober 2, 2025
Certification dateOctober 2, 2025
Mailing address3935 W 64th Pl, Chicago, IL 60629-4714

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