Basic Information
| Provider Information | |||||||||
| NPI: | 1184763542 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOLFMAN | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9301 GOLF RD | ||||||||
| Address2: | SUITE 302 | ||||||||
| City: | DES PLAINES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600161667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472968151 | ||||||||
| FaxNumber: | 8472963915 | ||||||||
| Practice Location | |||||||||
| Address1: | 9301 GOLF RD | ||||||||
| Address2: | SUITE 302 | ||||||||
| City: | DES PLAINES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600161667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472968151 | ||||||||
| FaxNumber: | 8472963915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 02/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036095827 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.