Individual
DR. NUSRAT A HAWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
4906 PEIFER LN, CHAMPAIGN, IL 61822-8321
(217) 531-1852
(217) 531-1853
Mailing address
4906 PEIFER LN, CHAMPAIGN, IL 61822-8321
(217) 531-1852
(217) 531-1853
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019025812
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6889
—
IL
Enumeration date
12/08/2006
Last updated
11/23/2011
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