Dr. Stephen E. Wallace
M.D. | Pediatrics | Male
Dr. Stephen E. Wallace, M.D. is a Springfield, Illinois based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Dr. Stephen E. Wallace is
2532 Farragut Dr, Springfield, Illinois - 62704-1433. He can be contacted on phone at
217-787-9424.
Dr. Stephen E. Wallace is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Stephen E. Wallace is
1548360134 which was assigned by NPPES on 23 Sep, 2006 and it was last updated on 29 Jan, 2009.
Dr. Stephen E. Wallace license number is
036-055346 for Pediatrics (208000000X) in Illinois.
Dr. Stephen E. Wallace is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Dr. Stephen E. Wallace basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Dr. Stephen E. Wallace |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Dr. Stephen E. Wallace address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 2532 Farragut Dr
Springfield, IL, 62704-1433
United States |
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| Phone Number : | 217-787-9424 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1548360134 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 23 Sep, 2006 |
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| Last Updated On : | 29 Jan, 2009 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Stephen E. Wallace are as mentioned. Primary taxonomy code for Dr. Stephen E. Wallace, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 036-055346 | IL |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Stephen E. Wallace such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 036055346 | MEDICAID | IL | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1025 S 6th St
Springfield, IL, 62703-2403
United States |
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| Phone Number : | 217-528-7541 |
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Business Location:
Patients can refer following map for directions to
Dr. Stephen E. Wallace practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.