Organization
ALLEGIS CARE-UTAH, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DIRK O WALES MD (CEO/OWNER)
(615) 564-3511
Entity
Organization
Contact information
Practice address
10808 SOUTH RIVER ROAD, SUITE 344, SOUTH JORDAN, UT 84095-6103
(773) 292-4800
(312) 564-4059
Mailing address
1340 S DAMEN AVE, SUITE 400, CHICAGO, IL 60608-1169
(773) 292-4800
(312) 564-4059
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
UT
207R00000X
Internal Medicine Physician
—
—
213E00000X
Podiatrist
—
—
Other
Enumeration date
04/13/2012
Last updated
09/02/2015
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