Provider Demographics
NPI:1588714372
Name:WOLNY, DENNIS J (DPM PC)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:WOLNY
Suffix:
Gender:M
Credentials:DPM PC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 142
Mailing Address - Street 2:251 FOUNDERS WAY
Mailing Address - City:PARK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60466-0142
Mailing Address - Country:US
Mailing Address - Phone:708-748-6292
Mailing Address - Fax:708-748-6988
Practice Address - Street 1:251 FOUNDERS WAY
Practice Address - Street 2:
Practice Address - City:PARK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60466-0142
Practice Address - Country:US
Practice Address - Phone:708-748-6292
Practice Address - Fax:708-748-6988
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0060000165OtherBLUE CROSS BLUE SHIELD
ILT36784Medicare UPIN
IL0060000165OtherBLUE CROSS BLUE SHIELD