Organization
CRYSTAL WONG O.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRYSTAL S WONG O.D. (PRESIDENT)
(312) 808-1893
Entity
Organization
Contact information
Practice address
2349 S WENTWORTH AVE, CHICAGO, IL 60616-2013
(312) 808-1893
Mailing address
2349 S WENTWORTH AVE, CHICAGO, IL 60616-2013
(312) 808-1893
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009664
IL
Other
Enumeration date
08/15/2011
Last updated
08/15/2011
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