Individual
DR. JASON C ONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1653 W CONGRESS PKWY, RUSH UNIVERSITY MEDICAL CENTER, CHICAGO, IL 60612-3833
(312) 942-5440
(312) 942-8961
Mailing address
1653 W CONGRESS PKWY, RUSH UNIVERSITY MEDICAL CENTER, CHICAGO, IL 60612-3833
(312) 942-5440
(312) 942-8961
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007474
IL
103TC0700X
Clinical Psychologist
PSY 21461
CA
Other
Enumeration date
06/05/2007
Last updated
05/21/2008
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