| Doctor Name: | DONALD R. WALLACE |
| NPI Number: | 1700899788 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 036-077680 |
| Business Practice Address: | 5114 N Glen Park Place Rd Peoria, IL - 616144686 |
| Business Phone Number: | 3096836600 |
| Business Fax Number: | |
| Mailing Address: | 5114 N Glen Park Place Rd, PEORIA |
| State: | IL |
| Postal Code: | 616144686 |
| Phone Number: | 3096836600 |
| Fax Number: | |
| NPI Enumeration Date: | 08/14/2006 |
| NPI Last Update Date: | 07/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207P00000X |
| License Number: | 036-077680 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Emergency Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |