Individual
CHRISTOPHER WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1919 SKOKIE VALLEY RD, HIGHLAND PARK, IL 60035-2361
(224) 765-5500
(224) 765-5501
Mailing address
900 RAND RD, SUITE 300, DES PLAINES, IL 60016-2359
(847) 324-3976
(847) 929-1154
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096-003950
IL
Other
Enumeration date
01/03/2017
Last updated
01/03/2017
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