James Alfred Wallace M.D.

NPI 1669687307 - Internal Medicine - 207RG0300X

NPI Details
NPI 1669687307
Gender Male
Enumeration Date 05/14/2007
Last Updated 08/19/2015
Entity Type Individual
Active Over 9 years ago
Practice Location
6701 159TH ST
TINLEY PARK IL, 60477-1758, US
Phone (708) 444-2226
Fax (708) 444-2224
Business Location
PO BOX 1119
MATTESON IL, 60443-4119, US
Phone (708) 862-7674
Fax (708) 747-9991
Taxonomy Code 207RG0300X
License State Illinois
License Number 036-113259
Remove 1669687307 NPI Number

According to our database, Dr. James Alfred Wallace M.D. NPI is 1669687307, taxonomy code is 207RG0300X and license number is 036-113259, license state is located at Illinois. James Alfred Wallace M.D. physically located at 6701 159th St, Tinley Park IL, 60477-1758. NPI Number James Alfred Wallace M.D. has the Individual type.

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1669687307 NPI number is provided on an as is basis without warranty of any kind. 1669687307 is maintained by the National Plan & Provider Enumeration System. The contents of James Alfred Wallace M.D. are for informational purposes only.