SearchIllinois1223G0001X

Kevin Wallace, DMD

NPI 1053423285 · on the registry since 2006

Practice

Address
150 E Huron St
Ste 1103
Chicago, IL 60611
Phone
(312) 676-9893
Fax
(815) 744-7059
Organisation at this address
Feely Ltd
Rci (Wrs), Llc.
The Womens Practice
Charles Lockhart Dds
Edward N Tuder Md Sc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
103

Registry record

Primary taxonomy
1223G0001X
1223G0001X
Also registered as
122300000X
122300000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-01-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois