Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DREW MICHAEL WALLACE, ATC
ActiveDREW MICHAEL WALLACE, ATC is a Athletic Trainer healthcare provider located in POPLAR GROVE, Illinois. NPI 1669878625 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · POPLAR GROVE, IL
Registration Details
- NPI Number
- 1669878625
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 18, 2014 (11.590375443208 yrs)
- Last Updated
- Nov 18, 2014
- License
-
200014924 (IL)
Practice Information
- Address
-
17823 POPLAR GROVE RDPOPLAR GROVE, IL, 610659014Browse IL providers · Browse ZIP 61065
- Phone
- 8157653311
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in POPLAR GROVE, IL
| Name | Credential | NPI |
|---|---|---|
| JOSEPH M ROCUSKIE | ATC | 1154815322 |
| JESSICA BALLARD | MS, ATC | 1568000768 |
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.