Charlesetta Wallace, APRN, CNM
NPI 1114896032ActiveIndividual· Advanced Practice Midwife· Bloomington, IL
Advanced Practice Midwife (APRN, CNM) with Osf Multi-Specialty Group, practicing in Bloomington, Illinois. Enrolled in Medicare as practitioner - certified nurse midwife (cnm).
Overview
| NPI | 1114896032 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | APRN, CNM |
| Sole proprietor | No |
| NPI issued | Oct 30, 2025 |
| Last updated in NPPES | Oct 30, 2025 |
| Certified by provider | Oct 30, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Advanced Practice Midwife Primary | 367A00000X | 209033647 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Certified Nurse Midwife (Cnm) (IL) |
|---|
Education and affiliations
| Graduation year | 2025 |
|---|---|
| Medicare specialty | Certified Nurse Midwife (Cnm) |
Medical group
- Osf Multi-Specialty GroupMorton, IL · 2,114 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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