Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | IL | |
Y | 208600000X | Surgeon | IL | |
N | 2086S0102X | Surgical Critical Care | IL | |
N | 2086S0127X | Trauma Surgeon | IL |
NPI | 1295940724 |
---|---|
Provider Name | Dr. Osmaan Abbas Khawaja |
First Address | Dixon, IL 61021-3166 |
Second Address | Dixon, IL 61021-3166 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 07/08/2007 |