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General NPI Number Information
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NPI Number | 1063699155
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Entity Type | Organization
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Legal Business Name | A.R.WOLFE, PH.D. AND ASSOCIATES
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 2518 N LINCOLN AVE #204
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City | CHICAGO
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State | IL
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Zip | 60614-2782
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Country | US
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Telephone | 312-593-8027
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Fax | 312-664-6389
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Provider Business Mailing Address
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Address Line | 680 N LAKE SHORE DR #304
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City | CHICAGO
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State | IL
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Zip | 60611-4546
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Country | US
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Telephone | 312-593-8027
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Fax | 312-664-6389
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | ANNE R. WOLFE
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Credential | PH.D.
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Telephone | 312-593-8027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071003493
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License Number State | IL
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