Individual
BETTY KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2701 PATRIOT BLVD, GLENVIEW, IL 60026-8039
(847) 666-5664
Mailing address
680 N LAKE SHORE DR, CHICAGO, IL 60611-4546
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036149176
IL
207N00000X
Dermatology Physician
125067947
IL
Other
Enumeration date
01/15/2015
Last updated
06/17/2019
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