ADAM N WALLACE

ROCKFORD, IL
NPI1801117585
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085N0700X Radiology, Neuroradiology
(Licence: IL  036.148822)
Additional Taxonomies2085N0700X Radiology, Neuroradiology
(Licence: WI  70505-20)
2085N0700X Radiology, Neuroradiology
(Licence: MN  61898)
2085R0202X Radiology, Diagnostic Radiology
(Licence: CO  DR.0068906)
2085R0202X Radiology, Diagnostic Radiology
(Licence: MO  2015013114)
2085R0202X Radiology, Diagnostic Radiology
(Licence: NY  319983)
2085R0202X Radiology, Diagnostic Radiology
(Licence: IL  036.148822)
2084N0400X Psychiatry & Neurology, Neurology
(Licence: WI  70505)
Enumeration Date2010-06-17
Last Update Date2023-12-15
Business Address
Dr. ADAM N WALLACE MD
8201 EAST RIVERSIDE BOULEVARD MERCY HEALTH JAVON BAE HOSPITAL
ROCKFORD, IL 61114-2300
Phone number: 815-971-5000
Mailing Address
Dr. ADAM N WALLACE MD
2301 N LAKE DR STE 1104
MILWAUKEE, WI 53211-4508
Phone number: 414-585-3223