Individual
MARK WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
251 E HURON ST, FEINBERG PAVILION, CHICAGO, IL 60611-2908
(312) 503-8144
(312) 502-8249
Mailing address
251 E HURON ST, FEINBERG PAVILION, CHICAGO, IL 60611-2908
(312) 503-8144
(312) 502-8249
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
125055907
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125055907
125055907
IL
Enumeration date
06/16/2009
Last updated
06/16/2009
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