MEDICARE: WAHID KASSAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	036107989	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	206147	OTHER	IL	MEDICARE PTAN (GROUP)
3	F400094850	OTHER	IL	MEDICARE PTAN (INDIVIDUAL)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	P00078735	OTHER	IL	RR MEDCIARE PTAN (INDIVIDUAL)

General Provider Information

NPI Number	:	1144203647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAHID KASSAR M.D.

Provider Business Mailing Address
First Line	:	7447 W TALCOTT AVE STE 467
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-3715
Country	:	US
Telephone Number	:	630-866-3636
Fax Number	:	773-692-2035

Provider Business Practice Location Address
First Line	:	7447 W TALCOTT AVE STE 467
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-3715
Country	:	US
Telephone Number	:	630-866-3636
Fax Number	:	773-692-2035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	10/02/2025

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Directions to “ WAHID KASSAR M.D.” Practice Location

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