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General NPI Number Information
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NPI Number | 1386887701
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Entity Type | Individual
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Provider Name | MIN WANG M.D. PHD
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Gender | Male
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Dates
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Enumeration Date | 04/15/2009
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 1431 OPUS PL STE 110
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1164
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Country | US
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Telephone | 888-279-0002
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Fax | 773-989-2781
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-343-3064
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Fax | 239-343-9193
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME150087
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036131692
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME150087
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License Number State | FL
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