Individual
DR. GREGORY AARON WALLMAN
Active
Individual
DR. GREGORY AARON WALLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036107048
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912186024
GROUP NPI
IL
01
—
216024
GROUP PTAN
IL
01
—
26-1093600
GROUP FEIN
IL
Enumeration date
08/19/2006
Last updated
03/23/2015
Update your record
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