Kendall L Wong, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

36106966 Issued in IL

Practice address

2200 Fort Jesse Rd
Suite 280
Normal, IL 61761-6286

Phone

(309) 452-1788

Fax

(309) 862-1302

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bloomington Radiology S C

  • Diagnostic Radiology Physician
  • Normal, IL
  • NPI 1700831773
  NPD (past)
• Ft. Jesse Imaging Center LLC

  • Radiology Clinic/Center
  • Normal, IL
  • NPI 1245287143

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386683076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 FORT JESSE RD",
            "address_2": "SUITE 280",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616286",
            "telephone_number": "309-452-1788",
            "fax_number": "309-862-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FORT JESSE RD",
            "address_2": "SUITE 280",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616286",
            "telephone_number": "309-452-1788",
            "fax_number": "309-862-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KENDALL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "36106966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036106966*1",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Herbert Wiser, MD
• Emily Wolf, CST
• Nicole Wolters
• Fred F Woltz III, CST
• Ragenia Woltz, CST
• Rachel Erin Wood, AU.D.
• Shermian Antoinette Woodhouse, MD
• Jessica Rodgers Worland, DOULA
• Wright Chiropractic Health Center
• Donald Lee Wright, D.C.

• Diagnostic Radiology Physician in Normal, IL
• Providers in Normal, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.