Individual
WARA AHSAN IMAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-3282
Mailing address
917 SAINT STEPHENS GRN, OAK BROOK, IL 60523-2569
(630) 433-0729
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
125.077463
IL
Other
Enumeration date
04/02/2021
Last updated
01/06/2022
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