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Search › Illinois › 183500000X

Kennis Wallace, RPH

NPI 1811981939 · on the registry since 2005

Practice

Address
303 S Commercial St
Parker Plaza
Harrisburg, IL 62946
Phone
(618) 253-7621
Fax
(618) 252-7455
Organisation at this address
Fenton Dialysis Llc
Deaconess Illinois Clinic, Inc
Deaconess Illinois Clinic, Inc
Deaconess Illinois Specialty Clinic, Inc.
Integrated Health Of Southern Illinois, Ltd.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
10

Registry record

Primary taxonomy
183500000X
183500000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-07-13

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