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General NPI Number Information
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NPI Number | 1568993657
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Entity Type | Individual
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Provider Name | KHAJA M. SIRAJ D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 3815 HIGHLAND AVENUE SUITE AIP
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1500
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Country | US
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Telephone | 708-283-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 3815 HIGHLAND AVENUE SUITE AIP
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1500
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Country | US
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Telephone | 708-283-5500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125.070904
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036150771
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036150771
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 036.150771
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License Number State | IL
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