Individual
DR. MICHAEL WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
6141 N LINCOLN AVE, CHICAGO, IL 60659-2313
(773) 596-5651
Mailing address
1209 W ARTHUR AVE APT 415, CHICAGO, IL 60626-6258
(312) 315-5879
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011263
IL
Other
Enumeration date
11/28/2018
Last updated
11/28/2018
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