Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Dr. Elizabeth Nicole Wallis , MD

Pediatrics β€’ Bloomington, IL

Active NPI 1821551334 Individual Practitioner Female Practitioner
Practice location in NPPES

200 W Monroe St Ste 302
Bloomington, IL 617013997

Call 3092046766 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

200 W Monroe St Ste 302

Bloomington, IL 617013997

Telephone 3092046766

Open Payments general payments, program year 2025

All general payments: $147.53 across 9 records.

By nature of payment

  • Food and Beverage: $147.53 across 9 records.

Reporting-company totals (3 largest of 6)

  • Supernus Pharmaceuticals, Inc.: $47.32 across 3 records.
  • Abbott Laboratories: $27.80 across 1 record.
  • Corium, LLC: $20.15 across 2 records.

A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.

See the full table

Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).

Guide: How to read an Open Payments record

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Wallis has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Wallis as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Bloomington and Illinois

13 active clinicians are listed under Pediatrics with a practice address in Bloomington, IL (3,178 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Bloomington

0% of these 13 clinicians have the CMS telehealth indicator.

15.4% of these 13 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2025
Disclosure Year:

Program year 2025 (payments made January 1 – December 31, 2025): fewer than 11 records totaling $147.53.

Manufacturer Payment Nature Product Type Amount ($)
Abbott Laboratories
Food and Beverage
In-kind items and services
FREESTYLE LIBRE 3 General $27.80
Corium, LLC
Food and Beverage
In-kind items and services
Azstarys General $19.07
Janssen Pharmaceuticals, Inc
Food and Beverage
In-kind items and services
SPRAVATO General $18.44
Sanofi and Genzyme US Companies
Food and Beverage
In-kind items and services
TZIELD General $18.00
Supernus Pharmaceuticals, Inc.
Food and Beverage
In-kind items and services
Qelbree General $17.09
Supernus Pharmaceuticals, Inc.
Food and Beverage
In-kind items and services
Qelbree General $16.42
Collegium Pharmaceutical, Inc.
Food and Beverage
Cash or cash equivalent
Jornay PM General $15.82
Supernus Pharmaceuticals, Inc.
Food and Beverage
In-kind items and services
Qelbree General $13.81
Corium, LLC
Food and Beverage
In-kind items and services
Azstarys General $1.08

Source: CMS Open Payments, program year 2025, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-08-03
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES LA 331615

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

License # reported to NPPES IL 036.176418

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PEDIATRIC MEDICINE

Medicare Enrollment ID

I20221027002483

Enrollment State Jurisdiction

LA

PECOS Control ID

3779950100

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
πŸ“
Updated Practice Location August 03, 2026

Registered at 200 W MONROE ST STE 302, BLOOMINGTON, IL 617013997 (Tel: 3092046766)

πŸ“
Updated Business Mailing Address August 03, 2026

Registered at 200 W MONROE ST STE 302, BLOOMINGTON, IL 617013997 (Tel: 3092046766)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 03, 2026

Pediatrics (license number reported to NPPES: IL 036.176418)

πŸ“
Updated Practice Location June 29, 2022

Registered at 1937 S BURNSIDE AVE, GONZALES, LA 707374632 (Tel: 2257655500)

πŸ“
Updated Business Mailing Address June 29, 2022

Registered at 5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 708166038 (Tel: 2257655500)

βœ…
NPI Profile Active April 11, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 11, 2019

Registered at 7777 HENNESSY BLVD STE 6004, BATON ROUGE, LA 708084300 (Tel: 2257653368)

πŸ“
Business Mailing Address (Initial Record) April 11, 2019

Registered at 7777 HENNESSY BLVD STE 6004, BATON ROUGE, LA 708084300 (Tel: 2257653368)

πŸ‘€
Provider Name / Credentials (Initial Record) April 11, 2019

Recorded as ELIZABETH WALLIS, MD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 11, 2019

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration April 11, 2019

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1821551334
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 11, 2019
Last Update: August 03, 2026
Sole Proprietor: No

Other Pediatrics Specialists in Bloomington

Healthcare providers in Bloomington

Mailing Address

200 W Monroe St Ste 302

Bloomington, IL 617013997

Phone: 3092046766

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.