Individual
HISHAM ALWAKKAA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2521 CEDAR HILL LN, WOODRIDGE, IL 60517-4273
(203) 212-7241
Mailing address
2521 CEDAR HILL LN, WOODRIDGE, IL 60517-4273
(203) 212-7241
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036163665
IL
2085R0202X
Diagnostic Radiology Physician
163655
IL
208D00000X
General Practice Physician
70164
CT
Other
Enumeration date
05/04/2017
Last updated
12/28/2023
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