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MR. JAMES EDWARD WALLACE JR. PA-C
NPI 1053539783
Physician Assistant in Champaign, IL

Active since April 20, 2007
101 W UNIVERSITY AVE, SPINE AND PAIN MANAGEMENT, CHAMPAIGN, IL 61820(217) 366-8796(217) 366-6106 Get Directions Write a Review

NPPES record last updated: September 24, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. James Edward Wallace Jr. Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JAMES EDWARD WALLACE JR. PA-C (NPI 1053539783) is an individual physician assistant in Champaign, Illinois, licensed in Illinois (85000087) and active in the NPI registry since April 2007.

NPPES Registry Identity

NPI1053539783
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. JAMES EDWARD WALLACE JR.Credential: PA-C
Location Address101 W UNIVERSITY AVE, SPINE AND PAIN MANAGEMENTChampaign, IL 61820-3909
Mailing Address101 W University Ave, Spine And Pain ManagementChampaign, IL 61820-3909 · (217) 366-1326 · Fax (217) 366-6106
Phone(217) 366-8796
Fax(217) 366-6106
Sole ProprietorNo
Enumeration DateApril 20, 2007
Last NPPES UpdateSeptember 24, 2013
✔ NPI 1053539783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IL · 85000087
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
101 W UNIVERSITY AVE, Champaign, IL 61820
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Other Identifiers 3

Medicare ID-Type Unspecified590860IL
Medicare NSC0533210001IL
Medicare UPINP11543

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELLEN FLORA
Physician Assistant
101 W UNIVERSITY AVE
CHAMPAIGN, IL 61820
Champaign County (217) 366-1248
JASMINE A EVANS PT, DPT
Physical Therapist
101 W UNIVERSITY AVE
CHAMPAIGN, IL 61820
Champaign County (217) 366-1323
MRS. SARAH SHOEMAKER CNM
Advanced Practice Midwife
101 W UNIVERSITY AVE
CHAMPAIGN, IL 61820
Champaign County (217) 366-1255
PATRICIA FAIRCHILD OT
Occupational Therapist
101 W UNIVERSITY AVE
CHAMPAIGN, IL 61820
Champaign County (217) 366-1323
MR. RICHARD JEAN A.T.C.
Specialist/Technologist (Athletic Trainer)
101 W UNIVERSITY AVE
CHAMPAIGN, IL 61820
Champaign County (217) 366-1327
MS. CATHY HINTON C.N.M.
Advanced Practice Midwife
101 W UNIVERSITY AVE
CHAMPAIGN, IL 61820
Champaign County (217) 366-1255
WHITNEY KAUFFMAN PA
Physician Assistant (Medical)
101 W UNIVERSITY AVE
CHAMPAIGN, IL 61820
Champaign County (217) 366-8107
DR. SALIM G. KHAZOUM MD
Pathology (Anatomic Pathology & Clinical Pathology)
101 W UNIVERSITY AVE
CHAMPAIGN, IL 61820
Champaign County (217) 337-2310

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Wallace's NPI number?

The NPI number for James Wallace is 1053539783. It was assigned to this individual provider in the NPPES registry on April 20, 2007.

Where is James Wallace located?

James Wallace practices at 101 W University Ave Spine And Pain Management, Champaign, IL 61820. The listed phone number is (217) 366-8796.

What is James Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for James Wallace was last updated on September 24, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.