NPI 1003899071
John Wall, MD
Practice location
- Address
- 1200 W State St, Rockford, IL 61102-2112
- Phone
- (815) 490-1600
- Mailing address
- 480 Meridian St, Village of Lakewood, IL 60014-5416
Registered specialties
Family Medicine Physician
Primary
Registry record
- NPI
- 1003899071
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 23 Nov 2005
- Record last updated
- 13 Jul 2026
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.