| Organization Name: | EDWARD WOLPERT MD SC LTD |
| NPI Number: | 1356586481 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDWARD A WOLPERT (PRESIDENT) |
| Mailing Address: | 156 W Jefferson Spring Green |
| State: | WI US |
| Postal Code: | 53588 |
| Phone Number: | 6085882600 |
| Fax Number: | 6085882644 |
| NPI Enumeration Date: | 12/03/2008 |
| NPI Last Update Date: | 02/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 071002659 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |