Healthcare Provider Details

I. General information

NPI: 1104409796
Provider Name (Legal Business Name): WAJEEHA AKHTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6155 GRAND AVE
GURNEE IL
60031-1651
US

IV. Provider business mailing address

6155 GRAND AVE
GURNEE IL
60031-1651
US

V. Phone/Fax

Practice location:
  • Phone: 847-535-7647
  • Fax:
Mailing address:
  • Phone: 847-535-7647
  • Fax: 847-535-8109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number036.169564
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: