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Individual

DR. WAJAHAT HUMAYUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-5911
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.160040
IL
207RI0011X
Interventional Cardiology Physician
036.160040
IL
208M00000X
Hospitalist Physician
Primary
036.160040
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103267796
PA
Enumeration date
06/24/2014
Last updated
02/11/2023
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