Individual
DR. THEODORE WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3134 N CLARK ST, CHICAGO, IL 60657-4414
(773) 880-9722
(312) 766-4908
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036079516
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
036079516
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036079516
—
IL
Enumeration date
08/23/2006
Last updated
10/05/2022
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