Individual
DR. AUGUSTINE CHU-KWAN WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3502 N KEDZIE AVE, CHICAGO, IL 60618-1103
(773) 654-1888
(773) 754-7412
Mailing address
3502 N KEDZIE AVE, CHICAGO, IL 60618-1103
(773) 654-1888
(773) 754-7412
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-094438
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094438
—
IL
Enumeration date
05/10/2006
Last updated
01/28/2024
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