MEDICARE: ISAAC POHLMAN LLC

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
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1700770203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISAAC POHLMAN LLC

Provider Business Mailing Address
First Line	:	2150 W LAWRENCE AVE APT 301
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-1586
Country	:	US
Telephone Number	:	906-286-2752
Fax Number	:

Provider Business Practice Location Address
First Line	:	2150 W LAWRENCE AVE APT 301
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-1586
Country	:	US
Telephone Number	:	906-286-2752
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. ISAAC JAMES POHLMAN
Credential	:	MPH, RD, LD
Telephone Number	:	906-286-2752

Provider Enumeration Date	:	06/07/2025
Last Update Date	:	06/07/2025

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