Provider Demographics
NPI:1801090220
Name:WOLBER, AMBERLY K (MD)
Entity type:Individual
Prefix:DR
First Name:AMBERLY
Middle Name:K
Last Name:WOLBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:22285 N PEPPER RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2540
Mailing Address - Country:US
Mailing Address - Phone:847-382-5080
Mailing Address - Fax:847-382-0923
Practice Address - Street 1:22285 N PEPPER RD STE 201
Practice Address - Street 2:
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2540
Practice Address - Country:US
Practice Address - Phone:847-382-5080
Practice Address - Fax:847-382-0923
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41104208800000X
NC2013-01108208800000X
FLME152478208800000X
IL036.169412208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100018160Medicaid
KY6416540001Medicare NSC
KY7100018160Medicaid
KYK134270Medicare PIN