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NPI Code Detail

MEDICARE: RICHARD JOHN WOLFE M.D.

MEDICARE: RICHARD JOHN WOLFE M.D.
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
1207QG0300XGeriatric Medicine (Family Medicine) Physician036-105593IL
2207QH0002XHospice and Palliative Medicine (Family Medicine) Physician036105593IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679668123
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD JOHN WOLFE M.D.
Provider Business Mailing Address
First Line : 1550 BISHOP CT
Second Line :
City : MOUNT PROSPECT
State : IL
Zip : 60056-6039
Country : US
Telephone Number : 847-685-9900
Fax Number :
Provider Business Practice Location Address
First Line : 1550 BISHOP CT
Second Line :
City : MOUNT PROSPECT
State : IL
Zip : 60056-6039
Country : US
Telephone Number : 847-685-9900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 10/19/2016

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