Doctor Name: | ALLAN J OLTHOFF |
NPI Number: | 1780731067 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | |
Business Practice Address: | 400 Lake Cook Rd 200c Deerfield, IL - 600155607 |
Business Phone Number: | 8472670260 |
Business Fax Number: | |
Mailing Address: | 4524 S Oakenwald Ave, CHICAGO |
State: | IL |
Postal Code: | 606534514 |
Phone Number: | 3126233007 |
Fax Number: | |
NPI Enumeration Date: | 01/05/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |