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NPI Code Detail

MEDICARE: HELENA L WANG MD

MEDICARE:   HELENA L WANG  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician036103779IL
2207RP1001XPulmonary Disease Physician036103779IL
3207R00000XInternal Medicine PhysicianA109282CA
4207RC0200XCritical Care Medicine (Internal Medicine) PhysicianA109282CA
5207RP1001XPulmonary Disease PhysicianA109282CA

General Provider Information

NPI Number : 1538190368
Entity Type Code : Individual
Provider Name (Legal Business Name) : HELENA L WANG MD
Provider Business Mailing Address
First Line : 2160 S FIRST AVE 101-1740
Second Line : LOYOLA UNIVERSITY MEDICAL CENTER
City : MAYWOOD
State : IL
Zip : 60153
Country : US
Telephone Number : 708-216-9000
Fax Number : 708-216-9033
Provider Business Practice Location Address
First Line : 2351 CLAY ST STE 501
Second Line : SAN FRANCISCO CRITICAL CARE MEDICAL GROUP
City : SAN FRANCISCO
State : CA
Zip : 94115-1931
Country : US
Telephone Number : 415-923-3421
Fax Number : 415-600-1414
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 08/28/2009

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