Individual
ANJUM S OWAISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
396 REMINGTON BLVD, SUITE 330, BOLINGBROOK, IL 60440-4302
(888) 220-6432
(630) 654-4253
Mailing address
901 MCCLINTOCK DR, SUITE 202, BURR RIDGE, IL 60527-0872
(888) 220-6432
(630) 654-4253
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036-110632
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-110632
MEDICAL LICENSE NUMBER
IL
05
—
036110632
—
IL
Enumeration date
02/09/2007
Last updated
12/17/2021
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