PETER WONG (NPI# 1952344509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
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 |
Address | Telephone Number | Fax Number |
---|---|---|
4069 Lake Dr Se, S-312, Grand Rapids, MI 495468816 | 6162678700 |
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 |
Street Address |
2 GOOD SAMARITAN WAY STE 235 |
City | MOUNT VERNON |
State | IL |
Zip Code | 62864-2476 |
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 |
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 Code | 2086S0129X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Vascular Surgery |
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. |
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 |
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 |
City | MOUNT VERNON |
Zip Code | 62864 |
Please comment or provide details below to improve the information on PETER WONG.
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.