| Dr Stephen E Wallace, MD | |
|
2532 Farragut Dr, Springfield, IL 62704-1433 | |
| (217) 787-9424 | |
| Not Available |
| Full Name | Dr Stephen E Wallace |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 2532 Farragut Dr, Springfield, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548360134 | NPI | - | NPPES |
| 036055346 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 036-055346 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Stephen E Wallace, MD 1025 S 6th St, Springfield, IL 62703-2403 Ph: (217) 528-7541 | Dr Stephen E Wallace, MD 2532 Farragut Dr, Springfield, IL 62704-1433 Ph: (217) 787-9424 |
Stephanie E. Wojtowicz, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2532 Farragut Dr, Springfield, IL 62704 Phone: 217-787-9424 | |
Claudine Gillison, Pediatrics Medicare: Medicare Enrolled Practice Location: 2532 Farragut Dr, Springfield, IL 62704 Phone: 217-528-7541 | |
Gopinathan Gangadharan Nambiar, Pediatrics Medicare: Medicare Enrolled Practice Location: 2901 Old Jacksonville Rd, Springfield, IL 62704 Phone: 217-698-9722 Fax: 217-391-0392 | |
Dr. Susan M. Soler, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2532 Farragut Dr, Springfield, IL 62704 Phone: 217-787-9424 | |
Dr. Kimberly Nichole Powell, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 415 N 9th St, Suite 4w16, Springfield, IL 62702 Phone: 217-545-8000 Fax: 217-757-6654 | |
John Padanilam, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 400 N 9th St # 4a, Springfield, IL 62702 Phone: 217-545-8000 | |
Misty M. Phillips, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2532 Farragut Dr, Springfield, IL 62704 Phone: 217-528-7541 |