Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1407010176 Individual Practitioner Male Practitioner

Douglas M Wallen

Dentist - General Practice • Champaign, IL

Professional Overview & Biography Verified Profile Summary

Douglas Wallen is a registered healthcare professional specializing in Dentist - General Practice in Champaign, IL. Practice services are available at 2502 GALEN DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2502 Galen Dr
Suite 103

Champaign, IL 618217045

Telephone 2173660050
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Champaign, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
46 Specialists

Practicing in Champaign, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 019020653

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 11, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location July 11, 2008

Registered at 2502 GALEN DR, SUITE 103, CHAMPAIGN, IL 618217045 (Tel: 2173660050)

📍
Updated Business Mailing Address July 11, 2008

Registered at 2502 GALEN DR, SUITE 103, CHAMPAIGN, IL 618217045 (Tel: 2173660050)

👤
Provider Name / Credentials Updated July 11, 2008

Recorded as DOUGLAS WALLEN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 11, 2008

Dentist (License #019020653 in IL)

🟢
Initial NPI Registration & Enumeration July 11, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1407010176
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 11, 2008
Last Update: July 11, 2008
Sole Proprietor: Yes

Mailing Address

2502 Galen Dr, Suite 103

Champaign, IL 618217045

Phone: 2173660050

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.