Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 036126420 | IL |
Y | 207Q00000X | Family Doctor | 125.053851 | IL |
N | 207RN0300X | Nephrologist | 036126420 | IL |
NPI | 1013154327 |
---|---|
Provider Name | Dr. Wasay Humayun |
First Address | Chicago, IL 60625-3657 |
Second Address | Chicago, IL 60625-3657 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2009 |
Last Update Date | 16/12/2016 |