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

Sara S Wallis, AGACNP

Individual provider Acute Care Nurse Practitioner · NPI 1912760141

Sara S Wallis, AGACNP is a Nurse Practitioner in Decatur, Illinois. Qualified in 2023, 3 years ago. Practices with Decatur Memorial Hospital, a 169-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
3
Licensed in
IL
In the registry since
2024

Practice location Address checks out

2300 N Edward St
Decatur, IL 62526-4163
Phone: (217) 876-4200
Fax: (217) 876-4209
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 209029068 (IL)

Record details

NPI number1912760141
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedJanuary 31, 2024
Last updated in NPPESSeptember 25, 2024
Certification dateSeptember 25, 2024
Mailing address2300 N Edward St, Decatur, IL 62526-4163

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Decatur Memorial Hospital — 169 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Decatur