Provider Demographics
NPI:1801800974
Name:WOLF, HARVEY IRA (DDS)
Entity type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:IRA
Last Name:WOLF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 S BARRINGTON RD
Mailing Address - Street 2:STE 3
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-7400
Mailing Address - Country:US
Mailing Address - Phone:847-382-5511
Mailing Address - Fax:847-382-0841
Practice Address - Street 1:1410 S BARRINGTON RD
Practice Address - Street 2:STE 3
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-7400
Practice Address - Country:US
Practice Address - Phone:847-382-5511
Practice Address - Fax:847-382-0841
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice