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

Mr. James Edward Wallace Jr., PA-C

Individual provider Physician Assistant · NPI 1053539783

Mr. James Edward Wallace Jr., PA-C is a Physician Assistant in Champaign, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

101 W University Ave Spine And Pain Management
Champaign, IL 61820-3909
Phone: (217) 366-8796
Fax: (217) 366-6106
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 85000087 (IL)

Record details

NPI number1053539783
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 20, 2007
Last updated in NPPESSeptember 24, 2013

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