Individual
JODY WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
912 S WOOD ST, CHICAGO, IL 60612-4300
(312) 996-2019
Mailing address
912 S WOOD ST, CHICAGO, IL 60612-4300
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036160148
IL
2084P0802X
Addiction Psychiatry Physician
036160148
IL
Other
Enumeration date
04/10/2018
Last updated
06/27/2025
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