Provider Demographics
NPI:1619062478
Name:WOLZ HEALTH, INC
Entity type:Organization
Organization Name:WOLZ HEALTH, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORP. PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:G
Authorized Official - Last Name:WOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:FP-APRN,PMHCNS, BC
Authorized Official - Phone:618-559-3319
Mailing Address - Street 1:8714 DAY RD
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62902-0427
Mailing Address - Country:US
Mailing Address - Phone:618-559-3319
Mailing Address - Fax:
Practice Address - Street 1:8714 DAY RD
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62902-0427
Practice Address - Country:US
Practice Address - Phone:618-559-3319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-0001152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209110Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
IL624920Medicare ID - Type Unspecified
P42526Medicare UPIN