Healthcare Provider Details

I. General information

NPI: 1508423518
Provider Name (Legal Business Name): WALID SAYYED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2019
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N BOLINGBROOK DR STE A
BOLINGBROOK IL
60440-2386
US

IV. Provider business mailing address

210 N BOLINGBROOK DR STE A
BOLINGBROOK IL
60440-2386
US

V. Phone/Fax

Practice location:
  • Phone: 630-822-2242
  • Fax:
Mailing address:
  • Phone: 630-822-2242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.162302
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: