Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Donald R. Wallace, M.D.

Emergency Medicine Physician in Peoria, IL · enumerated 2006.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1700899788

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Registry record

Entity type Individual (Type 1)

Name Donald R. Wallace

Credential M.D.

Sex Male

Practice address 5114 N Glen Park Place Rd, Peoria, IL, 61614

Phone (309) 683-6600

Enumeration date Aug 14, 2006

Last updated in NPPES Jul 29, 2010

Taxonomy & licenses

207P00000X Emergency Medicine Physician Allopathic & Osteopathic Physicians · License 036-077680 (IL) Primary

MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential

Other identifiers

Identifier	Type	State	Issuer
036077680	Medicaid	IL	-
809840034	Other	IL	MEDICARE INDIVIDUAL PTAN
800810	Other	-	MEDICARE GROUP NO.
809840	Other	IL	MEDICARE GROUP PTAN

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What specialty is Donald Wallace?

Donald Wallace is registered in NPPES with the primary taxonomy of Emergency Medicine Physician. The taxonomy code describes the provider's classification and area of specialization for claims and credentialing.

Is this the official NPI registry?

No. NPI Portal is a private site built on public CMS NPPES data. The official registry is npiregistry.cms.hhs.gov, operated by CMS.

Other providers at this practice address

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Susan Sphar Midwife · Peoria, IL NPI 1477533057 Randall Wilcoxen Physician Assistant · Peoria, IL NPI 1851363022 Julie Alms-Dubois Nurse Practitioner · Peoria, IL NPI 1497716823 Jane Kalmes Medical Physician Assistant · Peoria, IL NPI 1205876166 Jessica Higgs Family Medicine Physician · Peoria, IL NPI 1588687800 Wade Carlson Family Medicine Physician · Peoria, IL NPI 1275557498 Randolph Mccrea Pediatrics Physician · Peoria, IL NPI 1891885182 Barry Miller Pediatrics Physician · Peoria, IL NPI 1891885190

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2010-07-29.