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1548360134
STEPHEN E. WALLACE
SPRINGFIELD, IL
NPI
1548360134
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: IL 036-055346)
Enumeration Date
2006-09-23
Last Update Date
2009-01-29
Business Address
Dr. STEPHEN E. WALLACE M.D.
2532 FARRAGUT DR
SPRINGFIELD, IL 62704-1433
Phone number: 217-787-9424
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Mailing Address
Dr. STEPHEN E. WALLACE M.D.
1025 S 6TH ST
SPRINGFIELD, IL 62703-2403
Phone number: 217-528-7541
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