Provider Demographics
NPI:1063510659
Name:WAHEED, MONA HABIBA (MD)
Entity Type:Individual
Prefix:DR
First Name:MONA
Middle Name:HABIBA
Last Name:WAHEED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2357 SEQUOIA DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-6222
Mailing Address - Country:US
Mailing Address - Phone:630-859-6800
Mailing Address - Fax:
Practice Address - Street 1:2285 SEQUOIA DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-6209
Practice Address - Country:US
Practice Address - Phone:630-859-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-115308207Q00000X
WAMD00042710207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0451514334OtherBLUESHIELD PROVIDER#
ILK35185Medicare PIN
IL0451514334OtherBLUESHIELD PROVIDER#
WAI06968Medicare UPIN