Crystal Wong O.D., P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009664 Issued in IL

Legal business name

CRYSTAL WONG O.D., P.C.

Practice address

2349 S Wentworth Ave
Chicago, IL 60616-2013

Phone

(312) 808-1893

NPI assigned

Aug 15, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Crystal S Wong, O.D.

Title

President

Phone

(312) 808-1893

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313366400000",
    "number": "1285913830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2349 S WENTWORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162013",
            "telephone_number": "312-808-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 S WENTWORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162013",
            "telephone_number": "312-808-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL WONG O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-15",
        "last_updated": "2011-08-15",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-808-1893",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.