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General NPI Number Information
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NPI Number | 1982606836
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Entity Type | Individual
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Provider Name | LAWRENCE DAVID WOLIN MD
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Gender | Male
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 06/01/2012
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Provider Practice Location Address
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Address Line | 1602 W CENTRAL RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-2407
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Country | US
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Telephone | 847-255-3515
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Fax | 847-255-8727
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Provider Business Mailing Address
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Address Line | 1602 W CENTRAL RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-2407
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Country | US
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Telephone | 847-255-3515
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Fax | 847-255-8727
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036059451
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License Number State | IL
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