Jessica Fae Wallace

NPI #1154202901 in Rolling Meadows, Illinois

Provider Information

NPI Number: 1154202901
Entity Type: Individual
Name: Jessica Fae Wallace
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dental Hygienist
Enumeration Date: Sep 9, 2025
Last Updated: Sep 9, 2025

Practice Location

Address: 2200 FLICKER LN
City: Rolling Meadows
State: Illinois
ZIP Code: 60008-1317
Phone: (815) 830-4739

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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