Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 036.140208 | IL |
NPI | 1194091074 |
---|---|
Provider Name | Dr. Birte Johanna Wolff |
First Address | Chicago, IL 60625-3645 |
Second Address | Chicago, IL 60625-3645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2012 |
Last Update Date | 05/05/2021 |