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Active NPI 1114896032 Individual Practitioner Female Practitioner

Charlesetta Wallace , APRN, CNM

Advanced Practice Midwife • Bloomington, IL

Professional Overview & Biography Verified Profile Summary

Charlesetta Wallace, APRN, CNM is a certified Advanced Practice Midwife practicing in Bloomington, IL. With approximately 1 years of clinical experience since completing medical education in 2025, Charlesetta Wallace delivers high-quality medical care to the local community at 2111 E OAKLAND AVE STE B.

Charlesetta Wallace does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

2111 E Oakland Ave Ste B

Bloomington, IL 617015783

Telephone 3098083068
Associated Practice Facility / Clinic
🏢 Advanced Womens Healthcare Sc Facility NPI 1376890426

Medicare Profile & Education

Medical School

Other

Graduation Year

2025

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Advanced Practice Midwife in Bloomington, IL

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
1 Yrs -1.0 yrs vs City Avg
City Avg: 2.0 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
11 Specialists

Practicing in Bloomington, IL (500 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wallace (1 Years) 1 Yrs
Bloomington Specialty Average (2.0 Years) 2.0 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-10-30
Advanced Practice Midwife Primary Specialty

NUCC Taxonomy Code: 367A00000X

State License IL 209033647

Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Lauren Heidenreich

Advanced Practice Midwife

NPI 1073490652
Michaela Kane

Advanced Practice Midwife

NPI 1205651825
Bethany Bradley , CNM

Advanced Practice Midwife

NPI 1235022542

Certified Nurse Midwife

Dr. Leigh Ann Kowalski , DO

Obstetrics & Gynecology

NPI 1427402494

Doctor of Osteopathic Medicine (D.O.)

Brittany King , APN

Nurse Practitioner

NPI 1427441815

Advanced Practice Nurse

Brittany Ziller , APN

Nurse Practitioner

NPI 1528722089

Advanced Practice Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 30, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location October 30, 2025

Registered at 2111 E OAKLAND AVE STE B, BLOOMINGTON, IL 617015783 (Tel: 3098083068)

📍
Updated Business Mailing Address October 30, 2025

Registered at 5100 W BRADFORD WOODS CIR APT T, PEORIA, IL 616158978 (Tel: 3093570768)

👤
Provider Name / Credentials Updated October 30, 2025

Recorded as CHARLESETTA WALLACE, APRN, CNM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 30, 2025

Advanced Practice Midwife (License #209033647 in IL)

🟢
Initial NPI Registration & Enumeration October 30, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114896032
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 30, 2025
Last Update: October 30, 2025
Sole Proprietor: No

Mailing Address

5100 W Bradford Woods Cir Apt T

Peoria, IL 616158978

Phone: 3093570768

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.