Individual
MR. KENNETH C WOLFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
7078 WEST AVE, HANOVER PARK, IL 60133
(630) 378-1225
(630) 378-1740
Mailing address
7078 WEST AVE, HANOVER PARK, IL 60133
(813) 854-1664
(630) 378-1740
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
23B.000007
IL
Other
Enumeration date
03/14/2006
Last updated
02/06/2009
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