IndividualActive
Adam Wallace, MD
NPI 1801117585 · Neuroradiology Physician · Rockford, IL
Provider details
- NPI number
- 1801117585
- Entity type
- Individual
- Primary specialty
- Neuroradiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 036.148822 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone: (815) 971-5000
Approximate (ZIP-level) locationGet directions
Mailing address
2301 N Lake Dr Ste 1104
Milwaukee, WI 53211-4508
Additional practice locations (3)
- 7505 Metro Blvd Ste 400Edina, MN 55439Phone: (612) 573-2200Fax: (612) 573-2274
- 2845 Greenbrier RdGreen Bay, WI 54311-6519Phone: (920) 288-8044Fax: (920) 288-8355
- 2301 N Lake Dr Ste 1104Milwaukee, WI 53211-4508Phone: (414) 215-9375Fax: (414) 585-3229
Registry dates
- Enumerated
- 2010-06-17
- Last updated
- 2026-04-22
- Certified
- 2026-04-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.