VINCENT WALLACE MA NPI 1144852260

NPI Information

NPI: 1144852260
Provider Name: VINCENT WALLACE, MA
Classification: Clinic/Center - 261QR0405X
Entity Type: Individual

Specialization: Rehabilitation, Substance Use Disorder

Address:
226 W ONTARIO ST
CHICAGO, IL
ZIP 60654
Phone: (312) 912-7008
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Vincent Wallace, MA is a rehabilitation and substance use disorder clinic center in Chicago, IL. Vincent Wallace, MA NPI is 1144852260. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

226 W ONTARIO ST
CHICAGO, IL
ZIP 60654-619
Phone: (312) 912-7008
Fax: (312) 533-2842

The enumeration date for this NPI number is 2/6/2020 and was last updated on 2/6/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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