DR. Adam N Wallace, MD

NPI #1801117585 in Rockford, Illinois

Provider Information

NPI Number: 1801117585
Entity Type: Individual
Name: DR. Adam N Wallace, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Radiology - Neuroradiology
Credential: MD
Enumeration Date: Jun 17, 2010
Last Updated: Dec 15, 2023

Practice Location

Address: 8201 EAST RIVERSIDE BOULEVARD
Address 2: MERCY HEALTH JAVON BAE HOSPITAL
City: Rockford
State: Illinois
ZIP Code: 61114-2300
Phone: (815) 971-5000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Radiology - Neuroradiology — Neuroradiology	2085N0700X	Primary
Radiology - Diagnostic Radiology — Diagnostic Radiology	2085R0202X
Psychiatry & Neurology - Neurology — Neurology	2084N0400X

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