Adam N Wallace, MD

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

License

036.148822 Issued in IL

Practice address

8201 E Riverside Blvd
Rockford, IL 61114-2300

Phone

(815) 971-5000

NPI assigned

Jun 17, 2010

Last updated

Apr 22, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 10

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI, AZ, NY, IL, TX5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 5

Specialty

Diagnostic Radiology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Columbia St Marys Hospital Milwaukee IncGroup PAC ID 5890604722, 311 clinicians

Premier Radiology Wisconsin LLCGroup PAC ID 9537595533, 111 clinicians

Sonoran Radiology LTDGroup PAC ID 3375964505, 466 clinicians

Associated Valley Radiologists, LTDGroup PAC ID 8325388499, 59 clinicians

Eagle Partners, PLLCGroup PAC ID 9032205752, 170 clinicians

Banner Imaging Services LLCGroup PAC ID 1850724386, 122 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051
• Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096
• Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
• Ascension St Francis Hospital Hospital, Milwaukee, WI, CCN 520078

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 67)

Interoperability endpoints

• Direct secure messaging: adam.wallace.1@11299.direct.athenahealth.com
• Direct secure messaging: awallacemd370998@carlehiedirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Associated Valley Radiologists LTD

  • Diagnostic Radiology Physician
  • Glendale, AZ
  • NPI 1932683257

  WI

  Medicare reassignment Care Compare group NPD
• Banner Imaging Services LLC

  • Diagnostic Radiology Physician
  • Sun City, AZ
  • NPI 1770139958
  Medicare reassignment Care Compare group NPD
• Columbia St. Mary's Hospital Milwaukee, Inc

  dba Ascension Columbia St Mary's Hospital Milwaukee

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1023064482

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Eagle Partners, PLLC

  • Diagnostic Radiology Physician
  • Duncan, OK
  • NPI 1548450976

  Neuroradiology, WI

  Medicare reassignment Care Compare group NPD
• Premier Radiology Wisconsin, LLC

  • Diagnostic Radiology Physician
  • Mount Pleasant, WI
  • NPI 1952951154
  Medicare reassignment Care Compare group NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708

  Diagnostic Radiology, WI

  Medicare reassignment Care Compare group NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment NPD
• Mercy Harvard Hospital Inc

  • Critical Access Hospital
  • Harvard, IL
  • NPI 1427001445
  Medicare reassignment NPD
• Rockford Health Physicians

  dba Mercyhealth Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD
• Baycare Aurora, LLC

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1255387726
  Medicare reassignment NPD
• Diagnostic Imaging Associates

  • Diagnostic Radiology Physician
  • Shreveport, LA
  • NPI 1194807271

  WI

  Medicare reassignment NPD
• Empire State Radiology P C

  • Diagnostic Radiology Physician
  • West Islip, NY
  • NPI 1255962783

  WI

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension All Saints Hospital, Inc

  dba Ascension All Saints Hospital

  • General Acute Care Hospital
  • Racine, WI
  • NPI 1639123284
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  dba Ascension SE Wisconsin Hospital-Elmbrook Campus

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1427007384
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  dba Ascension SE Wisconsin Hospital-Elmbrook Campus

  • Rehabilitation Hospital Unit
  • Brookfield, WI
  • NPI 1861417362
  Care Compare affiliation
• Ascension St Francis Hospital, Inc

  dba Ascension St Francis Hospital

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1225087190
  Care Compare affiliation
• Columbia St. Mary's Hospital Milwaukee, Inc.

  dba Ascension Columbia St Mary's Hospital Milwaukee Campus

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1871656082
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1801117585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 N LAKE DR STE 1104",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114508",
            "telephone_number": "414-585-3223",
            "fax_number": "414-585-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 E RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611142300",
            "telephone_number": "815-971-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 N Lake Dr Ste 1104",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532114508",
            "country_code": "US",
            "telephone_number": "414-215-9375",
            "fax_number": "414-585-3229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7505 Metro Blvd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "55439",
            "country_code": "US",
            "telephone_number": "612-573-2200",
            "fax_number": "612-573-2274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2845 Greenbrier Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116519",
            "country_code": "US",
            "telephone_number": "920-288-8044",
            "fax_number": "920-288-8355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ADAM",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-17",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036.148822",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "319983",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "WI",
            "license": "70505-20",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0068906",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MN",
            "license": "61898",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IL",
            "license": "036.148822",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036.148822",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "70505-20",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "70505-20",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2015013114",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200021565",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co. (Walgreens #9127)
• Walgreens
• Jimmy L Walker Jr., PA-C
• Lashonda Walker
• John Wall, MD
• Kiley Wallden, OTR/L
• Samuel Moore Wallden, D.M.D.
• Shawn Steven Wallery, D.C., M.D.
• Walmart Inc.
• Walmart Inc.

• Neuroradiology Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Neuroradiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.