PETER WONG


Address: 2 Good Samaritan Way Ste 235, Mount Vernon, IL 62864-2476
Phone: 6188993980

PETER WONG (NPI# 1952344509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952344509
Entity Type Individual
Full Name PETER WONG
Credential MD
Practice Address 2 Good Samaritan Way Ste 235
Mount Vernon
IL 62864-2476
Mailing Address Po Box 955860 Mc 845
Saint Louis
MO 63195-2560
Practice Telephone 6188993980
Mailing Telephone 6364985944
Enumeration Date 2006-06-13
Last Update Date 2020-10-21
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0129X Surgery
Specialization: Vascular Surgery
036097977 IL Allopathic & Osteopathic Physicians
N 2086S0129X Surgery
Specialization: Vascular Surgery
4301076962 MI Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
4069 Lake Dr Se, S-312, Grand Rapids, MI 495468816 6162678700

Other Providers PETER WONG

NPI Name Taxonomy Address Enumeration
1467995241 Peter Wong Substance Abuse Rehabilitation Facility 4714 Broomtail Ct, Antioch, CA 94531-9305 2016-11-28
1790238426 Peter Wong Marriage & Family Therapist 5150 Sunrise Blvd Ste H1, Fair Oaks, CA 95628-4966 2016-07-29
1104229970 Peter Wong Pharmacist 899 Sir Winston St, Henderson, NV 89052-4959 2014-10-07
1477677987 Peter J Wong Pharmacist 14625 Sw Allen Blvd, Beaverton, OR 97007-3600 2007-03-19
1154493070 Peter J Wong Internal Medicine 601 Pavonia Avenue, Suite 301, Jersey City, NJ 07306 2006-11-15
1992806533 Peter S Wong Dentist 12715 Bel Red Rd, Ste 202, Bellene, WA 98005 2006-09-26
1811971567 Peter J Wong Obstetrics & Gynecology 200 Banning Street, Suite 320, Dover, DE 19904 2005-12-05
1649702598 Peter Wong Pharmacist 300 Pullman St Bldg G, Livermore, CA 94551-9756 2017-03-30
1154860849 Peter Wong Dentist 18519 Devonshire St, Northridge, CA 91324 2017-02-15
1952663932 Peter Lap Kei Wong Obstetrics & Gynecology 128 Mott Street Suite 501, New York, NY 10013-5041 2012-06-14

Office Location

Street Address 2 GOOD SAMARITAN WAY STE 235
City MOUNT VERNON
State IL
Zip Code 62864-2476

Providers in the same location

NPI Name Taxonomy Address Enumeration
1053954503 Fariahh Fazil Nurse Practitioner 2 Good Samaritan Way Ste 235, Mount Vernon, IL 62864-2476 2019-10-28
1790045417 Patricia Teschke Surgery 2 Good Samaritan Way Ste 235, Mount Vernon, IL 62864-2476 2012-05-29

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619438892 Melissa Pryer Dietitian, Registered 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 2019-03-28
1487145454 Chiropractic Wellness Center of Mt Vernon, LLC. Chiropractor 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 2018-05-24
1851889208 Kimberly Tate Counselor 4110 North Water Place, Mt. Vernon, IL 62864 2018-05-01
1871907790 University Hematology Oncology Inc Specialist #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 2014-06-18
1457771677 Dynamic Counseling and Consultation Services Social Worker 3600 S Water Tower Pl, Mt Vernon, IL 62864 2014-04-27
1619239431 Judith C Morgan Counselor 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 2012-06-08
1073888624 James Brian Verges Counselor 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 2012-03-15
1720352271 Lucinda M. Holdren Counselor 16338 North Illinois Highway 37, Mount Vernon, IL 62864 2012-03-01
1780978627 Jamie M Orange Physical Therapy Assistant 19958 Fairfield Rd, Mt. Vernon, IL 62864 2011-06-08
1780978791 Wendy Marie Claytor Speech-Language Pathologist 600 E Il Hwy 15, Mount Vernon, IL 62864 2011-06-07
Find all providers in zip 62864

Taxonomy Information

Taxonomy Code 2086S0129X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Vascular Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063606432 Mohammed Al-zoubaidi Surgery 2 Good Samaritan Way Ste 220, Mount Vernon, IL 62864-2476 2007-08-29
1225113814 Ogedi A Ohajekwe Surgery 145 N 5th Ave, Mount Vernon, NY 10550-1269 2006-10-25

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1396267324 Congress Vascular Center LLC Surgery 41 W Congress Pkwy Fl 1, Chicago, IL 60605-1531 2017-07-11
1043731300 Elmwood Park Vascular Center LLC Surgery 7230 W North Ave Ste 108, Elmwood Park, IL 60707-4261 2017-06-27
1588105811 Mickey Graphia Surgery 701 N 1st St # D346, Springfield, IL 62702 2017-03-20
1992126668 Vascular Specialists LLC Surgery 20060 Governors Dr Ste 102, Olympia Fields, IL 60461-1099 2013-12-26
1588959548 Patrick Michael Sullivan Neville Surgery 4600 Memorial Dr Ste 120, Belleville, IL 62226-5359 2011-06-17
1235454968 Margaret Claire Rigamer Surgery 1901 W Harrison St Dept Of, Chicago, IL 60612-3714 2010-04-06
1215251541 John V. White, Md, LLC Surgery 8816 W Dempster St, Niles, IL 60714-5109 2010-03-15
1710212733 Vascular Surgery and Interpretation S.c. Surgery 3330 W 177th St Ste 2c1, Hazel Crest, IL 60429-2184 2009-10-08
1538391792 Usa Vein Clinics of Chicago LLC Surgery 4141 Dundee Rd, Northbrook, IL 60062-2129 2009-08-20
1306010731 Tanq, Inc. Surgery 18510 S Marilynn Ct, Mokena, IL 60448-9517 2008-04-16
Find all providers with the same taxonomy

Competitor

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City MOUNT VERNON
Zip Code 62864

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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