Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036-084085 | IL |
N | 111NI0900X | Internist | 036-084085 | IL |
Y | 207RH0002X | Hospice and Palliative Medicine | 036-084085 | IL |
NPI | 1073527578 |
---|---|
Provider Name | Waqar Mian |
First Address | Oak Brook, IL 60523-1225 |
Second Address | Chicago, IL 60616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 11/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F38500 | (02) | IL |