MEDICARE: TSZ YAN WONG LPC

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
1	101YP2500X	Professional Counselor	178.019252	IL

General Provider Information

NPI Number	:	1932927068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TSZ YAN WONG LPC

Provider Business Mailing Address
First Line	:	820 W JACKSON BLVD STE 550
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-3053
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6600 S COTTAGE GROVE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-4127
Country	:	US
Telephone Number	:	312-572-7028
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2024
Last Update Date	:	09/27/2024

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Directions to “ TSZ YAN WONG LPC” Practice Location

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