Individual
BRIAN KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 W NORTH AVE, CHICAGO, IL 60647
(872) 588-0220
Mailing address
1564 N DAMEN AVE STE 208, CHICAGO, IL 60622-2102
(872) 588-9220
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008677
IL
Other
Enumeration date
08/20/2014
Last updated
11/15/2019
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