Individual
MR. MARK R. WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
533 W NORTH AVE., SUITE 200, ELMHURST, IL 60126-2100
(630) 941-3400
(360) 941-3421
Mailing address
533 W NORTH AVE., SUITE 200, ELMHURST, IL 60126-2100
(630) 941-3400
(360) 941-3421
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
019-015297
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019.015297
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021.000989
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019-015297
—
IL
Enumeration date
11/09/2006
Last updated
06/16/2010
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