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

Drew Michael Wallace, ATC

Individual provider Athletic Trainer · NPI 1669878625

Drew Michael Wallace, ATC is an Athletic Trainer in Poplar Grove, Illinois. Licensed in Illinois. Registered with an NPI since 2014.

Licensed in
IL
In the registry since
2014
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

See every abbreviation used in this directory →

Practice location Address checks out

17823 Poplar Grove Rd
Poplar Grove, IL 61065-9014
Phone: (815) 765-3311
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 200014924 (IL)

Record details

NPI number1669878625
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC
Sole proprietorNo
NPI enumeratedNovember 18, 2014
Last updated in NPPESNovember 18, 2014
Mailing address5061 Linden Rd, 5303, Rockford, IL 61109-5834

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