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General NPI Number Information
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NPI Number | 1780798397
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Entity Type | Organization
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Legal Business Name | WALLMAN MEDICAL ASSOCIATES, S.C.
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 2501 COMPASS RD SUITE 100
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City | GLENVIEW
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State | IL
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Zip | 60026-8000
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Country | US
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Telephone | 847-901-5200
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Fax | 847-901-5225
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Provider Business Mailing Address
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Address Line | 2501 COMPASS RD SUITE 100
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City | GLENVIEW
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State | IL
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Zip | 60026-8000
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Country | US
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Telephone | 847-901-5200
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Fax | 847-901-5225
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. GREGORY AARON WALLMAN
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Credential | DO
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Telephone | 847-901-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | IL
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