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Search › Illinois › 208000000X

Stephen Wallace, M.D

NPI 1548360134 · on the registry since 2006

Practice

Address
2532 Farragut Dr
Springfield, IL 62704
Phone
(217) 787-9424
Organisation at this address
Springfield Pediatric & Adolescent Ctr Lab
Inferred from a shared address, not stated in the registry.
Clinicians at this address
12

Registry record

Primary taxonomy
208000000X
208000000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2009-01-29

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