Active NPI 1063473031 Individual Practitioner Female Practitioner

Dr. Caroline Wolfe , MD

Internal Medicine • Glen Ellyn, IL

Professional Overview & Biography Verified Profile Summary

Dr. Caroline Wolfe, MD is a registered healthcare professional specializing in Internal Medicine in Glen Ellyn, IL. Practice services are available at 430 PENNSYLVANIA AVE under active NPI credentials.

Frequently performed procedures and clinical services include insertion of needle into vein for collection of blood sample, established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

430 Pennsylvania Ave

Glen Ellyn, IL 601374464

Telephone 6304699200

Associated Practice Facility / Clinic

🏢 Dupage Medical Group, Ltd. Facility NPI 1841435369

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Glen Ellyn, IL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 21.4 Yrs

State Avg: 28.9 Yrs

Regional Practice Density

18 Specialists

Practicing in Glen Ellyn, IL (7544 Statewide)

Telehealth Adoption Rate

66.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

59.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	147	135	$20.00	$8.40
99213 Established patient office or other outpatient visit, typically 15 minutes	111	98	$157.00	$94.50
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	95	95	$229.00	$133.37
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	84	80	$229.00	$133.22
80048 Blood test, basic group of blood chemicals (calcium, total)	61	59	$44.00	$8.29
83036 Hemoglobin A1C level	57	53	$50.00	$9.52
80061 Blood test, lipids (cholesterol and triglycerides)	48	47	$69.00	$13.12
80053 Blood test, comprehensive group of blood chemicals	46	46	$55.00	$10.35
84443 Blood test, thyroid stimulating hormone (TSH)	34	34	$86.00	$16.46
85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	20	20	$33.00	$6.34
93000 Routine ekg using at least 12 leads including interpretation and report	20	20	$72.00	$15.24
82570 Creatinine level to test for kidney function or muscle injury	14	14	$27.00	$5.08
82043 Urine microalbumin (protein) level	14	14	$30.00	$5.66
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	12	12	$40.00	$7.61

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	568	378	$20.00	$2.95
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	341	341	$229.00	$136.88
99213 Established patient office or other outpatient visit, typically 15 minutes	336	226	$157.00	$95.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	327	208	$229.00	$134.34
80061 Blood test, lipids (cholesterol and triglycerides)	224	217	$69.00	$13.22
80048 Blood test, basic group of blood chemicals (calcium, total)	197	172	$44.00	$8.23
83036 Hemoglobin A1C level	189	78	$50.00	$9.59
80053 Blood test, comprehensive group of blood chemicals	182	166	$55.00	$10.43
84443 Blood test, thyroid stimulating hormone (TSH)	121	104	$86.00	$16.60
G0008 Administration of influenza virus vaccine	99	97	$55.00	$31.09
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	88	88	$103.00	$70.25
93000 Routine ekg using at least 12 leads including interpretation and report	77	75	$72.00	$15.28
85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	61	56	$33.00	$6.39
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	49	44	$40.00	$7.24
82570 Creatinine level to test for kidney function or muscle injury	39	38	$27.00	$5.12
82043 Urine microalbumin (protein) level	39	38	$30.00	$5.71
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	31	29	$43.00	$24.55
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	29	29	$340.00	$175.45
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	24	$94.00	$60.20
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r	21	20	$300.00	$74.18
U0005 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within	20	19	$75.00	$24.71
G0009 Administration of pneumococcal vaccine	17	17	$55.00	$31.38
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	16	16	$352.00	$175.87
99441 Telephone medical discussion with physician, 5-10 minutes	16	16	$179.00	$58.91
82306 Vitamin d-3 level	14	14	$152.00	$27.48
82947 Blood glucose (sugar) level	12	12	$20.00	$3.87
G0103 Prostate cancer screening; prostate specific antigen test (psa)	11	11	$52.00	$19.08
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	11	11	$45.00	$17.85
84460 Liver enzyme (sgpt), level	11	11	$28.00	$5.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	622	381	$20.00	$2.97
99213 Established patient office or other outpatient visit, typically 15 minutes	379	246	$157.00	$97.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	368	226	$229.00	$138.99
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	368	368	$229.00	$142.62
83036 Hemoglobin A1C level	220	94	$50.00	$9.71
80061 Blood test, lipids (cholesterol and triglycerides)	209	201	$69.00	$13.39
80048 Blood test, basic group of blood chemicals (calcium, total)	201	181	$44.00	$8.42
80053 Blood test, comprehensive group of blood chemicals	168	153	$55.00	$10.56
G0008 Administration of influenza virus vaccine	147	146	$55.00	$17.97
90662 Influenza vaccine split virus, preservative free	139	138	$106.00	$65.11
84443 Blood test, thyroid stimulating hormone (TSH)	138	111	$86.00	$16.80
93000 Routine ekg using at least 12 leads including interpretation and report	104	102	$72.00	$15.98
85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	61	54	$33.00	$6.47
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	51	46	$40.00	$7.49
82043 Urine microalbumin (protein) level	46	46	$30.00	$5.78
82570 Creatinine level to test for kidney function or muscle injury	46	46	$27.00	$5.18
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r	31	28	$300.00	$75.00
G0009 Administration of pneumococcal vaccine	31	31	$55.00	$17.93
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	31	31	$361.00	$124.57
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	29	27	$43.00	$24.54
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	24	24	$352.00	$180.04
82306 Vitamin d-3 level	21	19	$152.00	$29.60
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	19	19	$340.00	$180.42
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	19	19	$94.00	$60.47
82947 Blood glucose (sugar) level	18	18	$20.00	$3.93
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	18	18	$45.00	$18.05
0012A Adm sarscov2 100mcg/0.5ml2nd	15	15	$85.00	$42.14
99441 Telephone medical discussion with physician, 5-10 minutes	15	14	$72.60	$49.27
82607 Cyanocobalamin (vitamin B-12) level	14	13	$77.00	$15.08
81001 Manual urinalysis test with examination using microscope, automated	13	13	$16.00	$3.17
83550 Iron binding capacity	13	11	$45.00	$8.74
83540 Iron level	13	11	$33.00	$6.47
99442 Telephone medical discussion with physician, 11-20 minutes	12	11	$113.00	$93.68
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	11	11	$39.00	$16.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	542	357	$20.00	$2.97
99213 Established patient office or other outpatient visit, typically 15 minutes	326	222	$157.00	$80.04
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	306	177	$229.00	$116.68
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	297	297	$229.00	$124.24
80061 Blood test, lipids (cholesterol and triglycerides)	210	210	$69.00	$13.32
83036 Hemoglobin A1C level	202	92	$50.00	$9.66
80048 Blood test, basic group of blood chemicals (calcium, total)	177	156	$44.00	$8.32
80053 Blood test, comprehensive group of blood chemicals	165	156	$55.00	$10.50
G0008 Administration of influenza virus vaccine	122	121	$55.00	$17.73
90662 Influenza vaccine split virus, preservative free	117	116	$106.00	$60.67
84443 Blood test, thyroid stimulating hormone (TSH)	110	98	$86.00	$16.70
93000 Routine ekg using at least 12 leads including interpretation and report	96	94	$72.00	$18.49
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	63	58	$40.00	$7.49
85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	49	42	$33.00	$6.43
82043 Urine microalbumin (protein) level	43	43	$30.00	$5.75
82570 Creatinine level to test for kidney function or muscle injury	43	43	$27.00	$5.15
G0009 Administration of pneumococcal vaccine	43	43	$55.00	$17.64
99442 Telephone medical discussion with physician, 11-20 minutes	42	36	$177.64	$80.85
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	31	29	$43.00	$24.96
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	30	30	$352.00	$182.49
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	27	26	$94.00	$48.31
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	27	27	$317.11	$118.26
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	26	26	$340.00	$178.64
86769 Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody	24	23	$126.00	$42.13
99441 Telephone medical discussion with physician, 5-10 minutes	21	20	$79.81	$47.68
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r	21	21	$300.00	$100.00
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	18	18	$45.00	$17.91
90670 Pneumococcal vaccine for injection into muscle	16	16	$254.00	$222.71
84460 Liver enzyme (sgpt), level	13	13	$28.00	$5.27
81001 Manual urinalysis test with examination using microscope, automated	12	12	$16.00	$3.15
83550 Iron binding capacity	12	11	$45.00	$8.67
83540 Iron level	12	11	$33.00	$6.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	598	366	$20.00	$2.94
99213 Established patient office or other outpatient visit, typically 15 minutes	470	277	$157.00	$78.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	361	196	$229.00	$115.44
G0008 Administration of influenza virus vaccine	307	307	$55.00	$17.39
90662 Influenza vaccine split virus, preservative free	281	281	$106.00	$54.86
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	256	256	$229.00	$123.71
83036 Hemoglobin A1C level	222	97	$50.00	$10.57
80061 Blood test, lipids (cholesterol and triglycerides)	218	210	$69.00	$14.58
80048 Blood test, basic group of blood chemicals (calcium, total)	179	166	$44.00	$9.21
80053 Blood test, comprehensive group of blood chemicals	168	161	$55.00	$11.51
84443 Blood test, thyroid stimulating hormone (TSH)	121	109	$86.00	$18.30
93000 Routine ekg using at least 12 leads including interpretation and report	101	98	$72.00	$18.06
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	71	71	$352.00	$182.43
G0009 Administration of pneumococcal vaccine	57	57	$55.00	$17.39
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	43	42	$40.00	$8.46
82570 Creatinine level to test for kidney function or muscle injury	42	42	$27.00	$5.63
82043 Urine microalbumin (protein) level	42	42	$30.00	$6.29
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	39	37	$94.00	$48.10
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	34	34	$340.00	$176.57
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	29	29	$124.00	$110.18
90670 Pneumococcal vaccine for injection into muscle	28	28	$254.00	$209.95
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	26	26	$38.00	$17.48
85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	25	25	$33.00	$7.04
81001 Manual urinalysis test with examination using microscope, automated	23	21	$16.00	$3.45
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	19	19	$45.00	$17.69
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	18	18	$39.00	$18.31
84460 Liver enzyme (sgpt), level	18	18	$28.00	$5.77
82607 Cyanocobalamin (vitamin B-12) level	14	14	$77.00	$16.41
82306 Vitamin d-3 level	13	13	$152.00	$32.23
69210 Removal of impacted ear wax	13	13	$116.00	$51.12

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	588	356	$20.00	$2.94
99213 Established patient office or other outpatient visit, typically 15 minutes	495	286	$157.00	$76.32
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	419	215	$229.00	$113.14
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	243	243	$229.00	$122.44
83036 Hemoglobin A1C level	239	106	$50.00	$11.75
80053 Blood test, comprehensive group of blood chemicals	220	204	$55.00	$12.73
80061 Blood test, lipids (cholesterol and triglycerides)	205	195	$69.00	$16.20
G0008 Administration of influenza virus vaccine	196	193	$55.00	$21.46
90662 Influenza vaccine split virus, preservative free	128	127	$105.16	$52.23
80048 Blood test, basic group of blood chemicals (calcium, total)	125	111	$44.00	$10.23
84443 Blood test, thyroid stimulating hormone (TSH)	111	98	$86.00	$20.33
93000 Routine ekg using at least 12 leads including interpretation and report	95	94	$72.00	$18.02
G0009 Administration of pneumococcal vaccine	75	75	$55.00	$21.46
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	66	61	$40.00	$9.40
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	63	62	$35.84	$17.48
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	52	52	$124.00	$105.59
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	51	51	$352.00	$180.04
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	26	26	$340.00	$174.28
85018 Blood count, hemoglobin	26	15	$12.00	$2.87
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	26	25	$94.00	$46.34
90670 Pneumococcal vaccine for injection into muscle	23	23	$254.00	$198.35
85014 Red blood cell concentration measurement	22	12	$12.00	$2.87
85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	19	18	$33.00	$7.82
81001 Manual urinalysis test with examination using microscope, automated	19	16	$16.00	$3.84
83540 Iron level	17	16	$33.00	$7.83
83550 Iron binding capacity	17	16	$45.00	$10.57
84460 Liver enzyme (sgpt), level	12	12	$28.00	$6.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	632	373	$20.00	$2.94
99213 Established patient office or other outpatient visit, typically 15 minutes	432	244	$157.00	$76.40
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	418	220	$229.00	$112.53
80053 Blood test, comprehensive group of blood chemicals	353	307	$55.00	$12.43
G0008 Administration of influenza virus vaccine	339	335	$55.00	$26.65
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	293	293	$30.00	$17.48
83036 Hemoglobin A1C level	249	115	$50.00	$13.05
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	247	247	$229.00	$121.30
80061 Blood test, lipids (cholesterol and triglycerides)	215	205	$69.00	$14.27
84443 Blood test, thyroid stimulating hormone (TSH)	151	126	$86.00	$22.59
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	121	102	$40.00	$10.37
G0009 Administration of pneumococcal vaccine	96	96	$55.00	$26.65
93000 Routine ekg using at least 12 leads including interpretation and report	94	91	$72.00	$18.03
80048 Blood test, basic group of blood chemicals (calcium, total)	90	70	$44.00	$11.07
90670 Pneumococcal vaccine for injection into muscle	52	52	$254.00	$185.08
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	46	46	$124.00	$94.60
90662 Influenza vaccine split virus, preservative free	33	33	$52.00	$48.05
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	31	31	$340.00	$173.52
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	30	30	$352.00	$178.71
82306 Vitamin d-3 level	27	26	$152.00	$39.80
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	20	20	$39.00	$18.21
83540 Iron level	16	13	$33.00	$8.70
83550 Iron binding capacity	16	13	$45.00	$11.75
85610 Blood test, clotting time	15	11	$20.00	$5.28
81001 Manual urinalysis test with examination using microscope, automated	15	14	$16.00	$4.26
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	14	14	$30.00	$18.65
69210 Removal of impacted ear wax	12	12	$116.00	$52.33

Medical Specialties & State Licenses

CMS Verified: 2021-03-26

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License IL 036076298

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

036076298 (IL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Dr. Nicole Lesak , PT, DPT

Physical Therapist

NPI 1003475146

Physical Therapist, Doctor of Physical Therapy

Dr. Akshay Patel , MD

Hospitalist

NPI 1003494220

Doctor of Medicine (M.D.)

Dr. Mary Kurland , MD

Radiology - Diagnostic Radiology

NPI 1043286917

Doctor of Medicine (M.D.)

Emma Servatius

Nurse Practitioner

NPI 1043801020

Dr. Daniel Danahey , MD, PhD

Otolaryngology - Plastic Surgery within the Head & Neck

NPI 1063499754

Doctor of Medicine (M.D.), Doctor of Philosophy (Ph.D.)

Dr. Tahmineh Abbasian , MD

Pediatrics - Neonatal-Perinatal Medicine

NPI 1093716276

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active February 02, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location February 02, 2011

Registered at 430 PENNSYLVANIA AVE, GLEN ELLYN, IL 601374464 (Tel: 6304699200)

📍

Updated Business Mailing Address February 02, 2011

Registered at 1860 PAYSPHERE CIR, CHICAGO, IL 606740018 (Tel: 6304699200)

👤

Provider Name / Credentials Updated February 02, 2011

Recorded as CAROLINE WOLFE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 02, 2011

Internal Medicine (License #036076298 in IL)

🟢

Initial NPI Registration & Enumeration March 30, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1063473031

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 30, 2006

Last Update: March 26, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1860 Paysphere Cir

Chicago, IL 606740018

Phone: 6304699200

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.