| Organization Name: | ALLAN J OLTHOFF DO SC |
| NPI Number: | 1003959933 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALLAN J OLTHOFF (PRESIDENT) |
| Mailing Address: | 400 Lake Cook Rd 200c Deerfield |
| State: | IL US |
| Postal Code: | 600155607 |
| Phone Number: | 8472670260 |
| Fax Number: | 8472823862 |
| NPI Enumeration Date: | 02/14/2007 |
| NPI Last Update Date: | 07/31/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 036064582 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |