Wollner, Timothy S

Wollner, Timothy S is an individual health care provider with primary practice located at 2850 W 95Th St Suite 101, Evergreen Park IL 60805-2735. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wollner, Timothy S can be contacted via phone (708) 425-9550.

Contact Information

Primary practice address
2850 W 95Th St Suite 101 Evergreen Park IL 60805-2735
Phone: (708) 425-9550
Fax: (708) 229-6084
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036073267 Illinois

Profile Details

NPI number 1427088061
LBN Legal business name Wollner, Timothy S
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Jan 21st, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427088061 NPPES
Illinois MEDICAID 036073267
Illinois Other 080055203

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