Healthcare Provider Details

I. General information

NPI: 1164532677
Provider Name (Legal Business Name): WAQAAR SALIM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 06/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 OGDEN AVENUE SUITE 203
OGDEN IL
60504
US

IV. Provider business mailing address

13920 CAMBRIDGE CIR
PLAINFIELD IL
60544-7376
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-6218
  • Fax:
Mailing address:
  • Phone: 815-254-1107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: