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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. ADAM N WALLACE, MD

Active

DR. ADAM N WALLACE, MD is a Neuroradiology healthcare provider located in ROCKFORD, Illinois. NPI 1801117585 is currently active in the NPPES registry. Verify at CMS.

Neuroradiology · ROCKFORD, IL

Registration Details

NPI Number
1801117585
Provider Type
Individual
Gender
Male
NPI Issued
Jun 17, 2010 (16.16014447435 yrs)
Last Updated
Dec 15, 2023
Licenses
70505-20 (WI)
61898 (MN)
DR.0068906 (CO)
2015013114 (MO)
319983 (NY)

Practice Information

Address
8201 EAST RIVERSIDE BOULEVARD
MERCY HEALTH JAVON BAE HOSPITAL
ROCKFORD, IL, 611142300
Browse IL providers · Browse ZIP 61114
Phone
8159715000
Primary Specialty
Neuroradiology
2085N0700X
Additional Specialty
Neuroradiology
Additional Specialty
Diagnostic Radiology
Additional Specialty
Diagnostic Radiology
Additional Specialty
Diagnostic Radiology

Other Neuroradiology Providers in ROCKFORD, IL

Name Credential NPI
DR. ALIX VINCENT MD 1003802265
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.