Wallace, Earnest

Wallace, Earnest is an individual health care provider with primary practice located at 13136 Western Ave , Blue Island IL 60406-2423. He recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as his primary health care specialty. Wallace, Earnest can be contacted via phone (708) 974-5815.

Contact Information

Primary practice address
13136 Western Ave Blue Island IL 60406-2423
Phone: (708) 974-5815
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1548658149
LBN Legal business name Wallace, Earnest
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2015
Last updated Jan 5th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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