Provider Demographics
NPI:1649325614
Name:WOLLIN, WARREN DALE II (DO)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:DALE
Last Name:WOLLIN
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:361 W GOLF RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60195-3607
Mailing Address - Country:US
Mailing Address - Phone:847-952-7447
Mailing Address - Fax:847-952-7445
Practice Address - Street 1:361 W GOLF RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60195-3607
Practice Address - Country:US
Practice Address - Phone:847-952-7447
Practice Address - Fax:847-952-7445
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036091172207Q00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine