Provider Demographics
NPI:1104057728
Name:WANG, JOE CHIITZUU (DC)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:CHIITZUU
Last Name:WANG
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 1:3103 111TH ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5067
Mailing Address - Country:US
Mailing Address - Phone:773-590-2000
Mailing Address - Fax:
Practice Address - Street 1:3103 111TH ST
Practice Address - Street 2:SUITE 121
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5067
Practice Address - Country:US
Practice Address - Phone:773-590-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-011489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor