Kevin Wallace, DMD
Kevin Wallace, DMD is a provider specialising in General Practice Dentistry in Chicago, IL, registered under NPI 1053423285. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 150 E HURON ST STE 1103, Chicago, IL 60611. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 019022339 | IL | General Practice Dentistry primary |
| 019022339 | IL | Dentist |
| 019-022339 | IL | Dentist |
This provider holds licence 019022339 issued in IL. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Oral Surgery
- PAC ID
- 1951691237
- Enrollment ID
- I20160620000860
Medicare enrolment is recorded as approved under the provider type Practitioner - Oral Surgery. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What General Practice covers
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. NUCC Health Care Provider Taxonomy, code 1223G0001X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 1223G0001X | General Practice Dentistry General Practice | 019022339 | IL | primary |
| 122300000X | Dentist | 019022339 | IL | |
| 122300000X | Dentist | 019-022339 | IL |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1053423285 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Sep 1, 2006 |
| Last updated | Jan 19, 2021 |
| Status | Active |
| Sole proprietor | No |
| Credential | DMD |
| Practice address |
150 E HURON ST STE 1103 Chicago, IL 60611 (312) 676-9893 Fax (815) 744-7059 |
| Mailing address |
14831 W 159TH ST STE 1 Lockport, IL 60491 |
| Other identifiers |
1053431981
· Other (IL) 1306177241 · Other (IL) 1205145554 · Other (IL) 1508198474 · Other (IL) 1760882005 · Other (IL) 1295165439 · Other (IL) 019-022339 · Other (IL) 1063649770 · Other (IL) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 5 | 3 | 4 | 2 | 3 | 2 | 8 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 1 | 3 | 8 | 2 | 6 | 2 | 7 |
Sum = 55 · next multiple of 10 = 60 · check digit = 5 · actual last digit = 5
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.