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Search › Illinois › 2086S0129X

Gabriel Wallace, MD

NPI 1609142074 · on the registry since 2012 · sole proprietor

Practice

Address
12251 S 80th Ave Ste 1520
Palos Heights, IL 60463
Phone
(708) 923-4200
Fax
(708) 923-4201
Organisation at this address
Ap Lab Partners Sc
Palos Diagnostics Sc
Palos Community Hospital
Palos Community Hospital
Palos Community Hospital
Inferred from a shared address, not stated in the registry.
Clinicians at this address
264

Additional practice sites

  • 1959 Ne Pacific St, Seattle, WA
  • 10258 Southwest Hwy Ste A, Chicago Ridge, IL

Registry record

Primary taxonomy
2086S0129X
2086S0129X
Also registered as
208600000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2023-08-31

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