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

Lance T Wallace, MD

Individual provider Internal Medicine Physician · NPI 1538100128

Lance T Wallace, MD is an Internal Medicine in Dyer, Indiana. Graduated from Southern Illinois University School of Medicine in 1990, 36 years ago. Practices with Specialty Physicians of Illinois LLC, a 112-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Illinois and Indiana.

Years since qualifying
36
Trained at
Southern Illinois University School of Medicine
Licensed in
IL, IN
In the registry since
2006
Specialties on file
2
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

2150 Gettler St Ste 400
Dyer, IN 46311-2385
Phone: (219) 864-4970
Fax: (219) 864-4990
Show map & directions

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

Additional practice locations (1)

  • 20939 S Cicero Ave, Matteson, IL 60443-1620 — (708) 709-9375

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 01095489A (IN)
Internal Medicine Physician Taxonomy 207R00000X · Licence 036085478 (IL)

Record details

NPI number1538100128
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 8, 2006
Last updated in NPPESJuly 15, 2026
Certification dateJuly 15, 2026
Mailing addressPo Box 781076, Detroit, MI 48278-1076

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 1990 (36 years in practice)
Group practice Specialty Physicians Of Illinois Llc — 112 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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