IndividualActive
Michael Wall, M.D.
NPI 1093772311 · Family Medicine Physician · Forsyth, IL
Provider details
- NPI number
- 1093772311
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 036071267 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
241 W Weaver Rd
Ste 145c
Forsyth, IL 62535-9799
Phone: (217) 876-5200
Fax: (217) 876-5205
Approximate (ZIP-level) locationGet directions
Mailing address
2300 N Edward St
Decatur, IL 62526-4163
Registry dates
- Enumerated
- 2006-04-28
- Last updated
- 2014-08-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.