Jiwon Lee Wang, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036.164733 Issued in IL

Practice address

1725 W Harrison St Ste 970
Chicago, IL 60612-3828

Phone

(312) 942-7100

NPI assigned

Jun 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1942824271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 970",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123828",
            "telephone_number": "312-942-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 970",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123828",
            "telephone_number": "312-942-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE WANG",
        "first_name": "JIWON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2023-06-20",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4351046341",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.164733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Lee Choi, MD
• Katherine Tan Lee Chuy, M.D.
• Lee Ferrenbach
• Kathryn Michelle Lee Noll, D.O.
• Laine Mercedes Lee Nunez, NURSE PRACTITIONER
• Lee Wichman LCPC Inc
• Elizabeth Joy Lee-Eng, CRNA
• Adrianna Jiaying Lee, MD
• Alexandra Lee
• Alexis Lee, PA-C

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.