Provider Demographics
NPI:1538283536
Name:WONG, KEITH HON WING (DC)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:HON WING
Last Name:WONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 N PLUM GROVE RD APT 306
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4657
Mailing Address - Country:US
Mailing Address - Phone:847-387-9452
Mailing Address - Fax:
Practice Address - Street 1:1089 N SALEM DR
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-1331
Practice Address - Country:US
Practice Address - Phone:847-387-9452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-17
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor