Provider Demographics
NPI:1093771875
Name:HASHEM, WADDAH J (MD)
Entity Type:Individual
Prefix:
First Name:WADDAH
Middle Name:J
Last Name:HASHEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1315 MACOM DR
Mailing Address - Street 2:STE 206
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-9361
Mailing Address - Country:US
Mailing Address - Phone:630-978-7015
Mailing Address - Fax:630-978-7043
Practice Address - Street 1:1315 MACOM DR
Practice Address - Street 2:STE 206
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-9361
Practice Address - Country:US
Practice Address - Phone:630-978-7015
Practice Address - Fax:630-978-7043
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics