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General NPI Number Information
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NPI Number | 1063815298
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Entity Type | Individual
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Provider Name | LINDA WONG PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 612 RAYMOND DR
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City | NAPERVILLE
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State | IL
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Zip | 60563-9788
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Country | US
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Telephone | 630-428-9171
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Fax |
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Provider Business Mailing Address
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Address Line | 1323 SUNNYBROOK DR
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City | NAPERVILLE
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State | IL
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Zip | 60540-4028
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Country | US
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Telephone | 630-301-4139
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051296839
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License Number State | IL
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