| Wali Sajjad Khan, APN-CRNA | |
|
8103 Route 53 Apt 2, Woodridge, IL 60517-3644 | |
| (630) 210-1740 | |
| Not Available |
| Full Name | Wali Sajjad Khan |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 8103 Route 53 Apt 2, Woodridge, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891465225 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 041428235 (Illinois) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 209.027773 (Illinois) | Primary |
| Entity Name | Endeavor Health Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497701882 PECOS PAC ID: 2163334699 Enrollment ID: O20040524000118 |
| Entity Name | Northstar Anesthesia Of Illinois, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962822395 PECOS PAC ID: 4688893878 Enrollment ID: O20140922000405 |
| Entity Name | Gottlieb Community Health Services Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013415603 PECOS PAC ID: 3375442999 Enrollment ID: O20180420000980 |
| Entity Name | Loyola Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376041954 PECOS PAC ID: 6305109547 Enrollment ID: O20180420002063 |
| Entity Name | Encore Anesthesia Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558987883 PECOS PAC ID: 3476979683 Enrollment ID: O20200819000850 |
| Entity Name | Ias Illinois Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265118723 PECOS PAC ID: 9638530991 Enrollment ID: O20230802002876 |
| Mailing Address | Practice Location Address |
|---|---|
| Wali Sajjad Khan, APN-CRNA 8103 Route 53 Apt 2, Woodridge, IL 60517-3644 Ph: (630) 210-1740 | Wali Sajjad Khan, APN-CRNA 8103 Route 53 Apt 2, Woodridge, IL 60517-3644 Ph: (630) 210-1740 |