Provider Demographics
NPI:1225490840
Name:WANG, JAMES C (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:WANG
Suffix:
Gender:
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 N SAINT CLAIR ST STE 15-200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5967
Mailing Address - Country:US
Mailing Address - Phone:312-695-8182
Mailing Address - Fax:312-695-4303
Practice Address - Street 1:675 N SAINT CLAIR ST STE 15-200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5967
Practice Address - Country:US
Practice Address - Phone:312-695-8182
Practice Address - Fax:312-695-4303
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.028395207Y00000X
IL036155286207Y00000X, 207YX0905X, 207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH57.028395OtherMD LICENSE