Healthcare Provider Details

I. General information

NPI: 1932091253
Provider Name (Legal Business Name): MUHAMMAD HASNAIN KHAWAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/21/2025
Certification Date: 07/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4646 N MARINE DR
CHICAGO IL
60640-5759
US

IV. Provider business mailing address

4750 N CLARENDON AVE APT 1202
CHICAGO IL
60640-6627
US

V. Phone/Fax

Practice location:
  • Phone: 773-878-8700
  • Fax:
Mailing address:
  • Phone: 224-631-7574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.085115
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: