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Cody Wallace
NPI 1386182038 · on the registry since 2017
Practice
- Address
- 12n854 Meadowlark Dr
Hampshire, IL 60140 - Phone
- (847) 652-6743
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Also registered as
- 2255A2300X
- Sex
- Male
- Record last updated
- 2017-02-02
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