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Individual

DR. WASIM KHAWAJA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
20201 CRAWFORD AVE, OLYMPIA FIELDS, IL 60461-1010
(708) 679-2160
(708) 679-2161
Mailing address
1020 S AHRENS AVE, LOMBARD, IL 60148-4004

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036110331
IL
208M00000X
Hospitalist Physician
Primary
036110331
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01606583
BCBS
IL
01
01634377
BCBS
IL
05
036110331
IL
01
P00292530
RAILROAD MEDICARE
IL
01
P00438945
RAILROAD MEDICARE
IL
Enumeration date
06/10/2006
Last updated
06/21/2023
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