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MR. WALLACE L VINSON RSA
NPI 1235360959
Specialist in Bolingbrook, IL

Active since July 29, 2009
260 S SCHMIDT RD STE G, BOLINGBROOK, IL 60440(630) 754-7760(630) 754-7761 Get Directions Write a Review

NPPES record last updated: October 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 6, 2023, Nov 20, 2019, Oct 30, 2018 (3 updates tracked since 2018).

About Mr. Wallace L Vinson Rsa NPPES

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

MR. WALLACE L VINSON RSA (NPI 1235360959) is an individual specialist in Bolingbrook, Illinois, licensed in Illinois (238000232) and active in the NPI registry since July 2009.

NPPES Registry Identity

NPI1235360959
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameMR. WALLACE L VINSONCredential: RSA
Location Address260 S SCHMIDT RD STE GBolingbrook, IL 60440-3087
Mailing Address260 S Schmidt Rd Ste GBolingbrook, IL 60440-3087 · (630) 754-7760 · Fax (630) 754-7761
Phone(630) 754-7760
Fax(630) 754-7761
Sole ProprietorNo
Enumeration DateJuly 29, 2009
Last NPPES UpdateOctober 6, 20233 updates tracked since enumeration
NPPES CertifiedOctober 6, 2023
✔ NPI 1235360959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in IL · 238000232
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Also ListedSpecialist/Technologist, Other · Surgical TechnologistTaxonomy 246ZS0410X
260 S SCHMIDT RD STE G, Bolingbrook, IL 60440
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Other Providers at the Same Location NPPES 3

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

SHEIK SHAFIUDEEN MOHAMED MEERASAHIB SURGICAL ASSISTANT
Specialist/Technologist, Other (Surgical Assistant)
260 S SCHMIDT RD STE G
BOLINGBROOK, IL 60440
Will County (630) 754-7760
NICOLE MARIE PHILLIPS RNFA
Registered Nurse
260 S SCHMIDT RD STE G
BOLINGBROOK, IL 60440
Will County (630) 754-7760
EPIC SURGICAL SOLUTIONS LLC
Physician Assistant (Surgical)
260 S SCHMIDT RD STE G
BOLINGBROOK, IL 60440
Will County (630) 754-7760

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 Wallace Vinson's NPI number?

The NPI number for Wallace Vinson is 1235360959. It was assigned to this individual provider in the NPPES registry on July 29, 2009.

Where is Wallace Vinson located?

Wallace Vinson practices at 260 S Schmidt Rd Ste G, Bolingbrook, IL 60440. The listed phone number is (630) 754-7760.

What is Wallace Vinson's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Wallace Vinson was last updated on October 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.