Healthcare Provider Details

I. General information

NPI: 1447366240
Provider Name (Legal Business Name): AIJAZ WALJI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3249 OAK PARK AVE
BERWYN IL
60402-3429
US

IV. Provider business mailing address

3040 W SALT CREEK LN ARLINGTON HEIGHTS
ARLINGTON HEIGHTS IL
60005-1069
US

V. Phone/Fax

Practice location:
  • Phone: 708-783-2226
  • Fax:
Mailing address:
  • Phone: 847-385-7323
  • Fax: 847-483-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036-089470
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036089470
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: