Individual ProviderMary L WallmanRegistered NurseNursing Service ProvidersPractice Address1015 W Lawrence Ave, Chicago, IL 60640-5017(773) 275-2586PECOS EnrollmentBased on the most recent information from CMS, provider Mary L Wallman does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1487354916Provider TypeIndividualFull NameWallman, Mary LCredentialRNGenderFemaleSole ProprietorNoEnumeration Date3/3/2023Last Updated3/3/2023Contact InformationPractice LocationPractice Address1015 W Lawrence Ave, Chicago, IL 60640-5017Phone(773) 275-2586FaxUnlisted FaxMailing LocationMailing Address1015 W Lawrence Ave, Chicago, IL 60640-5017PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense041.413631Illinois