Individual
DR. JENNIFER ROSES WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
25 E WASHINGTON ST, SUITE 606, CHICAGO, IL 60602-1708
(312) 444-1111
(312) 444-1953
Mailing address
25 E WASHINGTON ST, SUITE 606, CHICAGO, IL 60602-1708
(312) 444-1111
(312) 444-1953
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18003473A
IN
152WC0802X
Corneal and Contact Management Optometrist
Primary
046-0101777
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046-0101777
ILLINOIS LICENSE NUMBER
IL
Enumeration date
09/08/2008
Last updated
06/04/2009
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