Provider Demographics
NPI:1063699155
Name:A.R.WOLFE, PH.D. AND ASSOCIATES
Entity type:Organization
Organization Name:A.R.WOLFE, PH.D. AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-593-8027
Mailing Address - Street 1:680 N LAKE SHORE DR
Mailing Address - Street 2:#304
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4546
Mailing Address - Country:US
Mailing Address - Phone:312-593-8027
Mailing Address - Fax:312-664-6389
Practice Address - Street 1:2518 N LINCOLN AVE
Practice Address - Street 2:#204
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-2782
Practice Address - Country:US
Practice Address - Phone:312-593-8027
Practice Address - Fax:312-664-6389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071003493103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty