Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
VINCENT WALLACE, MA
Active Sole ProprietorVINCENT WALLACE, MA is a Substance Use Disorder Rehabilitation Facility healthcare provider located in CHICAGO, Illinois. NPI 1144852260 is currently active in the NPPES registry. Verify at CMS.
Substance Use Disorder Rehabilitation Facility · CHICAGO, IL
Registration Details
- NPI Number
- 1144852260
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 6, 2020 (6.4740156071331 yrs)
- Last Updated
- Feb 6, 2020
- Sole Proprietor
- Yes
Practice Information
- Address
-
226 W ONTARIO STCHICAGO, IL, 606543619Browse IL providers · Browse ZIP 60654
- Phone
- 3129127008
- Fax
- 3125332842
- Primary Specialty
-
Substance Use Disorder Rehabilitation Facility
261QR0405X
Other Substance Use Disorder Rehabilitation Facility Providers in CHICAGO, IL
| Name | Credential | NPI |
|---|---|---|
| MS. WANTING WALKER | LPC | 1477748374 |
| SIXTO GARCIA | CADC | 1437679255 |
| ANDRE D NEWSOME | MS, MS, MHS, CADC | 1568982809 |
| SHEKENA ANN MILLER | — | 1306477989 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.