Individual provider · Type 1 NPI

Wallace L. Vinson, RSA

Specialist · Bolingbrook, IL

NPI number 1235360959 Active

Practice location

260 S Schmidt Rd Ste G
Bolingbrook, IL 60440-3087

Call (630) 754-7760 Map

Fax (630) 754-7761

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X238000232 (IL)
Surgical Technologist 246ZS0410XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1235360959

Wallace L. Vinson, RSA's National Provider Identifier is 1235360959, issued on Jul 29, 2009. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Bolingbrook, IL. The record was last updated on Oct 6, 2023.