Individual
MICHELLE GLORIA WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
715 LAKE ST STE 806, OAK PARK, IL 60301-1417
(773) 312-3612
Mailing address
8534 MASON AVE, MORTON GROVE, IL 60053-3312
(224) 817-1956
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
IL
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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