| Doctor Name: | MS. HOLLY RENEE WOLFORD |
| NPI Number: | 1659770998 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 209011728 |
| Business Practice Address: | 3880 Salem Lake Dr Ste F Long Grove, IL - 600475292 |
| Business Phone Number: | 8477192220 |
| Business Fax Number: | 8477192265 |
| Mailing Address: | 3880 Salem Lake Dr, Ste F LONG GROVE |
| State: | IL |
| Postal Code: | 600475292 |
| Phone Number: | 8477192220 |
| Fax Number: | 8477192265 |
| NPI Enumeration Date: | 08/21/2014 |
| NPI Last Update Date: | 08/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 209011728 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |