| Dr Shawn Steven Wallery, DC, MD | |
|
2350 N. Rockton Ave, Rockford Health Physicians, Rockford, IL 61103 | |
| (815) 971-2000 | |
| Not Available |
| Full Name | Dr Shawn Steven Wallery |
|---|---|
| Gender | Male |
| Speciality | Neurology |
| Experience | 19 Years |
| Location | 2350 N. Rockton Ave, Rockford, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881851780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 038007829 (Illinois) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | 036125570 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorial Hospital Of Carbondale | Carbondale, IL | Hospital |
| Herrin Hospital | Herrin, IL | Hospital |
| Harrisburg Medical Center | Harrisburg, IL | Hospital |
| Good Samaritan Regional Hlth Center | Mount vernon, IL | Hospital |
| St Joseph Memorial Hospital | Murphysboro, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southern Illinois Medical Services Nfp | 3678677390 | 331 |
| Provider Name | Rockford Health Physicians |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1043242886 PECOS PAC ID: 2567374036 Enrollment ID: O20031103000584 |
| Provider Name | Mercy Health System Corporation |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1598718603 PECOS PAC ID: 7416860440 Enrollment ID: O20031111000307 |
| Provider Name | Southern Illinois Medical Services Nfp |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Shawn Steven Wallery, DC, MD 2350 N. Rockton Ave, Rockford Health Physicians, Rockford, IL 61103 Ph: (815) 971-2000 | Dr Shawn Steven Wallery, DC, MD 2350 N. Rockton Ave, Rockford Health Physicians, Rockford, IL 61103 Ph: (815) 971-2000 |