Jonathan Wallace, M.D.

Surgery Physician · Hoffman Estates, IL

Individual Active NPI

NPI number 1568422012

Practice location

4885 Hoffman Blvd
Suite 400
Hoffman Estates, IL 60192-3726
Phone
(847) 255-9697
Fax
(847) 255-9697

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NPI record

NPI
1568422012
Entity type
Individual (Type 1)
Enumeration date
March 27, 2006
Last updated
March 19, 2021
Certified
March 19, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Surgery Physician Primary 208600000X 036108563 IL
Specialist 174400000X 036108563 IL

Other practice locations (1)

  • 955 Beisner Rd, Elk Grove Village, IL 60007-3475 · (847) 640-5666

About Dr. Wallace

Jonathan Wallace, M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Surgery Physician (code 208600000X). The practice location is 4885 Hoffman Blvd, Suite 400, Hoffman Estates, IL 60192-3726. The NPI number 1568422012 was assigned on March 27, 2006 and the record was last updated on March 19, 2021.

Dr. Wallace lists 2 licenses in the registry: #036108563 (IL) for Surgery Physician; #036108563 (IL) for Specialist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jonathan Wallace, M.D.?

The NPI number is 1568422012.

What is the phone number of Dr. Wallace?

The phone number listed for the practice location is (847) 255-9697.

Where is Dr. Wallace located?

4885 Hoffman Blvd, Suite 400, Hoffman Estates, IL 60192-3726.

What is the taxonomy code for Dr. Wallace?

The primary taxonomy code is 208600000X – Surgery Physician; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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