Healthcare Provider Details
I. General information
NPI: 1063692853
Provider Name (Legal Business Name): WARREN E. WOLSCHLAGER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2007
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1408 S MAIN ST
ALGONQUIN IL
60102-2746
US
IV. Provider business mailing address
1408 S MAIN ST
ALGONQUIN IL
60102-2746
US
V. Phone/Fax
- Phone: 847-854-0829
- Fax: 847-854-6257
- Phone: 847-854-0829
- Fax: 847-854-6257
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
WARREN
E.
WOLSCHLAGER
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 847-854-0829