Basic Information
Provider Information
NPI: 1841630704
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAWAZ
FirstName: HASEEB
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 25 N WINFIELD RD STE 500
Address2:  
City: WINFIELD
State: IL
PostalCode: 601901379
CountryCode: US
TelephoneNumber: 6302320280
FaxNumber: 6302323895
Practice Location
Address1: 25 N WINFIELD RD STE 500
Address2:  
City: WINFIELD
State: IL
PostalCode: 601901379
CountryCode: US
TelephoneNumber: 6302320280
FaxNumber: 6302323895
Other Information
ProviderEnumerationDate: 06/25/2013
LastUpdateDate: 12/29/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/29/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X036153338ILY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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