Healthcare Provider Details

I. General information

NPI: 1891440780
Provider Name (Legal Business Name): SAHEJ WALIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SAINT ELIZABETH BLVD STE 4000
O FALLON IL
62269-1284
US

IV. Provider business mailing address

3 SAINT ELIZABETH BLVD STE 4000
O FALLON IL
62269-1284
US

V. Phone/Fax

Practice location:
  • Phone: 618-256-9355
  • Fax: 618-206-2332
Mailing address:
  • Phone: 618-256-9355
  • Fax: 618-206-2332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberDO.OP.70035004
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: