Individual
DR. BENJAMIN S. WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2760
(847) 570-2921
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2760
(847) 570-2921
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036.134525
IL
Other
Enumeration date
06/13/2010
Last updated
06/15/2023
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