Individual
ASHIR WAHAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19400 NORTH CREEK DRIVE, LYNWOOD, IL 60411-8742
(708) 474-0410
(708) 474-0328
Mailing address
PO BOX 639295 DEPT 93394, CINCINNATI, OH 45263-9295
(248) 434-6169
(855) 618-6655
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036096993
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036096993
—
IL
01
—
080188117
MEDICARE RAILROAD
IL
Enumeration date
05/05/2006
Last updated
11/18/2022
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