DREW MICHAEL WALLACE ATC
NPI 1669878625
Specialist/Technologist - Athletic Trainer in Poplar Grove, IL

Q: What is Drew Wallace's NPI number?

The NPI number for Drew Wallace is 1669878625. It was assigned to this individual provider in the NPPES registry on November 18, 2014.

Q: What is Drew Wallace's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

Q: When was this NPI record last updated?

The NPPES record for Drew Wallace was last updated on November 18, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since November 18, 2014

17823 POPLAR GROVE RD, POPLAR GROVE, IL 61065(815) 765-3311 Get Directions Write a Review

NPPES record last updated: November 18, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Drew Michael Wallace Atc NPPES

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

DREW MICHAEL WALLACE ATC (NPI 1669878625) is an individual athletic trainer provider in Poplar Grove, Illinois, licensed in Illinois (200014924) and active in the NPI registry since November 2014.

NPPES Registry Identity

NPI1669878625

Entity TypeIndividualMale

Primary Taxonomy2255A2300X

Provider Legal NameDREW MICHAEL WALLACECredential: ATC

Location Address17823 POPLAR GROVE RDPoplar Grove, IL 61065-9014

Mailing Address5061 Linden Rd, #5303Rockford, IL 61109-5834 · (815) 878-5391

Phone(815) 765-3311

Sole ProprietorNo

Enumeration DateNovember 18, 2014

✔ NPI 1669878625 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2255A2300X

License✔ Licensed in IL · 200014924

Definition

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

17823 POPLAR GROVE RD, Poplar Grove, IL 61065

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Other Providers at the Same Location NPPES

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

JESSICA BALLARD MS, ATC

Specialist/Technologist (Athletic Trainer)

17823 POPLAR GROVE RD
POPLAR GROVE, IL 61065

Boone County (815) 765-3311

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 Drew Wallace's NPI number?

The NPI number for Drew Wallace is 1669878625. It was assigned to this individual provider in the NPPES registry on November 18, 2014.

Where is Drew Wallace located?

Drew Wallace practices at 17823 Poplar Grove Rd, Poplar Grove, IL 61065. The listed phone number is (815) 765-3311.

What is Drew Wallace's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

When was this NPI record last updated?

The NPPES record for Drew Wallace was last updated on November 18, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.