Individual
RICKY WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2650 RIDGE AVE, KELLOGG 3RD FLOOR, CHICAGO, IL 60201-1447
(847) 570-1440
Mailing address
2650 RIDGE AVE STE 1223, EVANSTON, IL 60201-1700
(847) 570-2040
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
125054462
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036126958
STATE LICENSE
IL
Enumeration date
01/27/2009
Last updated
04/28/2021
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