Mr James Edward Wallace Jr, PA-C - Physician Assistant in Champaign, IL

Mr James Edward Wallace Jr, PA-C is a Physician Assistant based in Champaign, Illinois. Mr James Edward Wallace Jr is licensed to practice in Illinois (license number 85000087) and his current practice location is 101 W University Ave, Spine And Pain Management, Champaign, Illinois. He can be reached at his office (for appointments etc.) via phone at (217) 366-8796.

NPI number for Mr James Edward Wallace Jr is 1053539783 and his current mailing address is 101 W University Ave, Spine And Pain Management, Champaign, Illinois. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1053539783.

Contact Information

Mr James Edward Wallace Jr, PA-C
101 W University Ave, Spine And Pain Management,
Champaign, IL 61820-3909
(217) 366-8796
(217) 366-6106



Provider's Profile

Full NameMr James Edward Wallace Jr
GenderMale
SpecialityPhysician Assistant
Location101 W University Ave, Champaign, Illinois
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1053539783
  • Provider Enumeration Date: 04/20/2007
  • Last Update Date: 09/24/2013

Medical Identifiers

Medical identifiers for Mr James Edward Wallace Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053539783NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 85000087 (Illinois)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr James Edward Wallace Jr is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr James Edward Wallace Jr, PA-C
101 W University Ave, Spine And Pain Management,
Champaign, IL 61820-3909

Ph: (217) 366-1326
Mr James Edward Wallace Jr, PA-C
101 W University Ave, Spine And Pain Management,
Champaign, IL 61820-3909

Ph: (217) 366-8796

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› Verified 5 days ago


Physician Assistant Nurses in Champaign, IL

Ellen Flora,
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 101 W University Ave, Champaign, IL 61820
Phone: 217-366-1248    
Kristine S Anderson, PA
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 1802 S Mattis Ave, Champaign, IL 61821
Phone: 217-383-3260    Fax: 217-383-4459
Jessica Sorensen, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 3101 Fields South Dr, Champaign, IL 61822
Phone: 217-366-1228    
Allen Thomas, P.A.-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1801 Windsor Rd, Champaign, IL 61822
Phone: 217-366-8130    Fax: 217-366-6106
Julie A Young, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1802 S. Mattis Avenue, Orthopedics, Champaign, IL 61821
Phone: 217-383-3260    Fax: 217-383-4459
Whitney Kauffman, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 101 W University Ave, Champaign, IL 61820
Phone: 217-366-8107    Fax: 217-366-6106

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