Wall, Jarrod C

Wall, Jarrod C is an individual health care provider with primary practice located at 747 N Rutledge St Fl 2 , Springfield IL 62702-6700. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Surgical Critical Care is his primary health care specialty. Wall, Jarrod C can be contacted via phone (217) 545-8000.

Contact Information

Primary practice address
747 N Rutledge St Fl 2 Springfield IL 62702-6700
Phone: (217) 545-8000
Fax: (217) 545-7795
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 46894 Minnesota
Allopathic & Osteopathic Physicians / Surgery 208600000X 036.121923 Illinois
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X 036-121923 Illinois

Profile Details

NPI number 1184695520
LBN Legal business name Wall, Jarrod C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2006
Last updated Jan 29th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184695520 NPPES
Illinois MEDICAID 036-121923
Illinois MEDICAID 492479700

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