Wallace, James Edward

Wallace, James Edward is an individual health care provider with primary practice located at 101 W University Ave Spine And Pain Management, Champaign IL 61820-3909. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Wallace, James Edward can be contacted via phone (217) 366-8796.

Contact Information

Primary practice address
101 W University Ave Spine And Pain Management Champaign IL 61820-3909
Phone: (217) 366-8796
Fax: (217) 366-6106
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 85000087 Illinois

Profile Details

NPI number 1053539783
LBN Legal business name Wallace, James Edward
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2007
Last updated Sep 24th, 2013 - about 11 years 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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