Search › Illinois › 207P00000X
Donald Wallace, M.D
NPI 1700899788 · on the registry since 2006
Practice
- Address
- 5114 N Glen Park Place Rd
Peoria, IL 61614 - Phone
- (309) 683-6600
- Clinicians at this address
- 45
Registry record
- Primary taxonomy
- 207P00000X
207P00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2010-07-29
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