Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Donald R. Wallace, MD

Individual provider Emergency Medicine Physician · NPI 1700899788

Donald R. Wallace, MD is an Emergency Medicine Physician in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5114 N Glen Park Place Rd
Peoria, IL 61614-4686
Phone: (309) 683-6600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 036-077680 (IL)

Record details

NPI number1700899788
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 14, 2006
Last updated in NPPESJuly 29, 2010
Mailing address5114 N Glen Park Place Rd, Peoria, IL 61614-4686

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