Provider Demographics
NPI:1124581749
Name:WONG, GARSENG (MD)
Entity type:Individual
Prefix:
First Name:GARSENG
Middle Name:
Last Name:WONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:625 N MICHIGAN AVE STE 2550
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3182
Mailing Address - Country:US
Mailing Address - Phone:312-640-7740
Mailing Address - Fax:312-640-7736
Practice Address - Street 1:625 N MICHIGAN AVE STE 2550
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3182
Practice Address - Country:US
Practice Address - Phone:312-640-7740
Practice Address - Fax:312-640-7736
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1597572084P0800X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry