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General NPI Number Information
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NPI Number | 1447352489
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Entity Type | Organization
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Legal Business Name | TONI ELLIS WOLF, DDS, PC
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 64 OLD ORCHARD PROFESSIONAL BUILDING SUITE 232
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City | SKOKIE
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State | IL
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Zip | 60077-1412
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Country | US
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Telephone | 847-673-2052
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Fax | 847-673-5002
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Provider Business Mailing Address
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Address Line | 64 OLD ORCHARD PROFESSIONAL BUILDING SUITE 232
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City | SKOKIE
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State | IL
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Zip | 60077-1412
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Country | US
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Telephone | 847-673-2052
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Fax | 847-673-5002
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TONI ELLIS WOLF
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Credential | DDS
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Telephone | 847-673-2052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | IL
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