Most Relevant Information
Provider Data
| NPI Number: | 1003043274 |
| Provider Name: | WILLIAM KWOK KUEN WAN M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 19.15068 |
Most Important Dates
| Enumeration Date: | 06/16/2009 |
| Last Updated: | 06/16/2009 |
Provider Practice Location
2262 S. WENTWORTH AVE
2ND FLOOR
CHICAGO
IL
60616
Practice Location Phone/Fax
| Phone: | 3127911013 |
| Fax: | 3127911444 |
Provider Mailing Location
2262 S. WENTWORTH AVE
2ND FLOOR
CHICAGO
IL
60616
Provider Mailing Phone/Fax
| Phone: | 3127911013 |
| Fax: | 3127911444 |