MEDICARE: LORI WOLFBERG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1174973556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI WOLFBERG

Provider Business Mailing Address
First Line	:	6302 HIDDEN OAK DR
Second Line	:
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60012-1249
Country	:	US
Telephone Number	:	815-353-2827
Fax Number	:

Provider Business Practice Location Address
First Line	:	6302 HIDDEN OAK DR
Second Line	:
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60012-1249
Country	:	US
Telephone Number	:	815-353-2827
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2016
Last Update Date	:	06/16/2016

Similar Medicare Providers

1013000835 — DR. MARY RIDGE D.C.
Practice Location Address:

1881 E MAIN ST
MOHEGAN LAKE, NY
10547-1249

Practice Phone: 914-528-8889
Practice Fax:

1811064447 — ALTERNATIVE SERVICES OREOGN, INC
Practice Location Address:

11830 KERR PKWY , SUITE 210
LAKE OSWEGO, OR
97035-1249

Practice Phone: 503-977-2262
Practice Fax: 503-977-2301

1518093871 — ADULT FAMILY & GROUP COUNSELING PLLC
Practice Location Address:

1920 LAKE SHORE DR , MEMORIAL UNITED METHODIST CHURCH OFFICES
GLADSTONE, MI
49837-1249

Practice Phone: 906-420-5844
Practice Fax: 906-474-6010

1952421943 — MS. MARTHA AMANDA YOUNG
Practice Location Address:

4287 E LAKE RD
SHEFFIELD LAKE, OH
44054-1249

Practice Phone: 440-308-3113
Practice Fax:

1699971937 — DR. NIKA DYAKINA D.O.
Practice Location Address:

1000 LAKE ST # 900C-6
RAMSEY, NJ
07446-1249

Practice Phone: 201-250-1579
Practice Fax: 201-283-9094

1801062211 — DR. ANTHONY THOMAS RUVOLO PHD
Practice Location Address:

1000 LAKE ST STE C8
RAMSEY, NJ
07446-1249

Practice Phone: 201-259-4037
Practice Fax: 201-825-7550

Directions to “ LORI WOLFBERG ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.