Organization
CHESTNUT MEDICINE OF WI LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAIR SIRAJ (CEO)
(703) 964-8199
Entity
Organization
Contact information
Practice address
1451 CLEVELAND AVE, WAUKESHA, WI 53186-3876
(262) 547-2123
(262) 547-6204
Mailing address
PO BOX 33, BEDFORD PARK, IL 60499-0033
(703) 964-8199
(703) 649-6188
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
03/03/2021
Last updated
05/27/2022
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