Wirtz, Edith

Wirtz, Edith is an sole proprietor health care provider with primary practice located at 111 E Main St , St Charles IL 60174-1948. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Wirtz, Edith can be contacted via phone (630) 587-3777.

Contact Information

Primary practice address
111 E Main St St Charles IL 60174-1948
Phone: (630) 587-3777
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 178008236 Illinois

Profile Details

NPI number 1023488640
LBN Legal business name Wirtz, Edith
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 26th, 2015
Last updated Sep 26th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023488640 NPPES
Illinois Other 721576970 TAXPAYER IDENTIFICATION NUMBER

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