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DAVID B. WALLACE M.D.
NPI 1295736809
Radiology - Diagnostic Radiology in Aurora, IL

Active since August 04, 2005
325 N HIGHLAND AVE, PROVENA MERCY MEDICAL CENTER, AURORA, IL 60506(630) 859-2222 Get Directions Write a Review

NPPES record last updated: May 13, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About David B. Wallace M.d. NPPES

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

DAVID B. WALLACE M.D. (NPI 1295736809) is an individual diagnostic radiology provider in Aurora, Illinois, licensed in Illinois (036050183) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1295736809
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameDAVID B. WALLACECredential: M.D.
Location Address325 N HIGHLAND AVE, PROVENA MERCY MEDICAL CENTERAurora, IL 60506-3811
Mailing Address520 E 22nd StLombard, IL 60148-6110 · (630) 874-2542 · Fax (630) 874-2642
Phone(630) 859-2222
Sole ProprietorNo
Enumeration DateAugust 4, 2005
Last NPPES UpdateMay 13, 2008
✔ NPI 1295736809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in IL · 036050183
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
325 N HIGHLAND AVE, Aurora, IL 60506
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Other Identifiers 3

Medicare UPINE18609IL
Medicare PINL74338IL
Medicare PINL53883IL

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 David Wallace's NPI number?

The NPI number for David Wallace is 1295736809. It was assigned to this individual provider in the NPPES registry on August 4, 2005.

Where is David Wallace located?

David Wallace practices at 325 N Highland Ave Provena Mercy Medical Center, Aurora, IL 60506. The listed phone number is (630) 859-2222.

What is David Wallace's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for David Wallace was last updated on May 13, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.