Individual
ANDI WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
260 E CHESTNUT ST APT 2005, CHICAGO, IL 60611-2457
(216) 213-8743
Mailing address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
TRN36059
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125080158
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
09/11/2018
Last updated
06/02/2024
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