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Individual

DR. GREGORY AARON WALLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2501 COMPASS RD, SUITE 100, GLENVIEW, IL 60026-8000
(847) 901-5200
(847) 904-4907
Mailing address
2501 COMPASS RD, SUITE 100, GLENVIEW, IL 60026-8000
(847) 901-5200
(847) 904-4907

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
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