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Donald W Wallace
Hearing Instrument Specialist in Decatur, Illinois
NPI 1467888537

Donald W Wallace is a Hearing Instrument Specialist based in Saint Charles, IL. Donald W Wallace practices in Decatur, IL. The NPI Number for Donald W Wallace is 1467888537 and holds a License No. 2013004501 (Illinois).

The current practice location address for Donald W Wallace is 3003 Pershing Ct Ste 101, Decatur, IL and can be reached out via phone at 217-330-9654. You can also correspond with Donald W Wallace through the mailing address at 3113 FLINTLOCK PATH, SAINT CHARLES, MO - 63301-3902 (mailing address contact number: 314-761-7510).

Location: 3003 Pershing Ct Ste 101, Decatur, IL, 63301-3902
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467888537
Provider Name
Donald W Wallace
Credential
Provider Entity Type
Individual
Gender
Male
Address
3003 Pershing Ct Ste 101, Decatur, IL, 63301-3902
Phone Number
217-330-9654
Fax Number
Provider Enumeration Date
09/20/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2013004501 01 MO HEARING AID DISPENSER LICENSE
3320 01 IL HEARING AID DISPENSER LICENCE
institution
Provider Business Practice Location Address Details
Address
3003 Pershing Ct Ste 101
City
Decatur
State
Illinois
Zip
62526-6323
Phone Number
217-330-9654
Fax Number
person
Provider Business Mailing Address Details
Address
3003 Pershing Ct Ste 101
City
Decatur
State
Illinois
Zip
62526-6323
Phone Number
217-330-9654
Fax Number
person
Provider's Taxonomy Details 1
Type
Speech, Language and Hearing Service Providers
Classification
Hearing Instrument Specialist
Speciality
-
Taxonomy
237700000X
License No.
2013004501 (Missouri)
Definition
Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society
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