Jonathan W Wallace (NPI# 1568422012, PAC ID# 8224109566) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1568422012 |
| PAC ID by PECOS | 8224109566 |
| Professional Enrollment ID | I20080613000594 |
| Full Name | Jonathan W Wallace |
| Organization Legal Name | SUBURBAN SURGICAL CARE SPECIALISTS, S.C |
| Address |
800 Biesterfield Rd Suite 101 Elk Grove Village IL 60007-3372 |
| Phone Number | 8472559697 |
| Gender | M |
| Medical School | TUFTS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1998 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 7113992918 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140258 | ALEXIAN BROTHERS MEDICAL CENTER 1 |
| 140290 | ST ALEXIUS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 800 Biesterfield Rd, Suite 101, Elk Grove Village, IL 60007-3372 | 8472559697 | SUBURBAN SURGICAL CARE SPECIALISTS, S.C |
| 4885 Hoffman Blvd, Suite 400, Hoffman Estates, IL 60192-3727 | 8472559697 | SUBURBAN SURGICAL CARE SPECIALISTS, S.C |
| 190 W Irving Park Rd, Wood Dale, IL 60191-1364 | 6307660412 | BONAVENTURE MEDICAL FOUNDATION LLC |
| Organization Legal Name | SUBURBAN SURGICAL CARE SPECIALISTS, S.C |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephanie K Meyers | Physician Assistant | Suburban Surgical Care Specialists, S.c | 4885 Hoffman Blvd, Suite 400, Hoffman Estates, IL 60192-3727 |
| Peter C Rantis Jr. | General Surgery | Suburban Surgical Care Specialists, S.c | 800 Biesterfield Rd, Suite 101, Elk Grove Village, IL 60007-3372 |
| Adam G Crane | Psychologist, Clinical | Suburban Surgical Care Specialists, S.c | 4885 Hoffman Blvd, Suite 400, Hoffman Estates, IL 60192-3727 |
| Trevor W Avella | Physician Assistant | Suburban Surgical Care Specialists, S.c | 800 Biesterfield Rd, Suite 101, Elk Grove Village, IL 60007-3372 |
| Emily Mary Winkelman | Physician Assistant | Suburban Surgical Care Specialists, S.c | 800 Biesterfield Rd, Suite 101, Elk Grove Village, IL 60007-3372 |
| James M Kane Jr. | General Surgery | Suburban Surgical Care Specialists, S.c | 800 Biesterfield Rd, Suite 101, Elk Grove Village, IL 60007-3372 |
| Gloria Kim | Physician Assistant | Suburban Surgical Care Specialists, S.c | 4885 Hoffman Blvd, Suite 400, Hoffman Estates, IL 60192-3727 |
| Kathleen M Zabor | Physician Assistant | Suburban Surgical Care Specialists, S.c | 4885 Hoffman Blvd, Suite 400, Hoffman Estates, IL 60192-3727 |
| Sydney A Krandel | Physician Assistant | Suburban Surgical Care Specialists, S.c | 4885 Hoffman Blvd, Suite 400, Hoffman Estates, IL 60192-3727 |
| Paul J Guske | General Surgery | Suburban Surgical Care Specialists, S.c | 4885 Hoffman Blvd, Suite 400, Hoffman Estates, IL 60192-3727 |
| Street Address |
800 BIESTERFIELD RD SUITE 101 |
| City | ELK GROVE VILLAGE |
| State | IL |
| Zip | 60007-3372 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Helen Zakos | Nurse Practitioner | Suburban Lung Associates Sc | 800 Biesterfield Rd, Suite 510, Elk Grove Village, IL 60007-3367 |
| Kody Lewis | Physician Assistant | Midwest Sports Medicine and Orthopaedic Surgical Specialists, Ltd. | 800 Biesterfield Rd, Elk Grove Village, IL 60007-3361 |
| Michael J Keller | Critical Care (intensivists) | Alexian Brothers Specialty Group | 800 Biesterfield Rd, Elk Grove Village, IL 60007-3361 |
| Hammad A Saudye | Interventional Cardiology | Alexian Brothers Specialty Group | 800 Biesterfield Rd, Elk Grove, IL 60007-3372 |
| Vitaliy A Vulykh | Certified Registered Nurse Anesthetist (crna) | Resolute Anesthesia Illinois Sc | 800 Biesterfield Rd, Elk Grove Village, IL 60007-3361 |
| Keith Welker | Physician Assistant | Suburban Orthopaedics Ltd | 800 Biesterfield Rd, Suite 565, Elk Grove Village, IL 60007-3362 |
| Barry M Glick | Internal Medicine | Elk Grove Medical Associates, LLC | 800 Biesterfield Rd, 705a, Elk Grove Village, IL 60007-3361 |
| Daniel D Vukas | Otolaryngology | Northwest Ent Associates, S.c. | 800 Biesterfield Rd, Suite 401, Elk Grove Village, IL 60007-3378 |
| Ronald D Lee | Urology | Uropartners LLC | 800 Biesterfield Rd, Elk Grove Village, IL 60007-3361 |
| Bassem Ghaly | Anesthesiology | Resolute Anesthesia Illinois Sc | 800 Biesterfield Rd, Elk Grove Village, IL 60007-3361 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leonor D Banez | Nurse Practitioner | Nani Elk Grove | 910 Bisterfield Rd, Suite 310, Elk Grove Village, IL 60007 |
| Richard Lee | Nephrology | Nani Elk Grove | 910 Bisterfield Rd, Suite 310, Elk Grove Village, IL 60007 |
| Samir T Kumar | Nephrology | Nani Elk Grove | 910 Bisterfield Rd, Suite 310, Elk Grove Village, IL 60007 |
| Anne C Allen | Physician Assistant | Nani Elk Grove | 910 Bisterfield Rd, Suite 310, Elk Grove Village, IL 60007 |
| Renee P Spacapan | Nurse Practitioner | Nani Elk Grove | 910 Bisterfield Rd, Suite 310, Elk Grove Village, IL 60007 |
| Naresh Julka | Nephrology | Nani Elk Grove | 910 Bisterfield Rd, Suite 310, Elk Grove Village, IL 60007 |
| Anand Brahmamdam | Diagnostic Radiology | Bright Light Radiologists Sc | 31 Arlington Heights Rd, Elk Grove Village, IL 60007-1405 |
| Monica Owerczuk | Diagnostic Radiology | Bright Light Radiologists Sc | 31 Arlington Heights Rd, Elk Grove Village, IL 60007-1405 |
| Ramit Mendi | Diagnostic Radiology | Bright Light Radiologists Sc | 31 Arlington Heights Rd, Elk Grove Village, IL 60007-1405 |
| Neal Sawlani | Cardiovascular Disease (cardiology) | Bright Light Radiologists Sc | 31 Arlington Heights Rd, Elk Grove Village, IL 60007-1405 |
| Find all physicians in zip 60007 | |||
| City | ELK GROVE VILLAGE |
| Zip Code | 60007 |
| Specialty | GENERAL SURGERY |
| City + Specialty | ELK GROVE VILLAGE + GENERAL SURGERY |
Please comment or provide details below to improve the information on Jonathan W Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.