Provider Demographics
NPI:1164532677
Name:SALIM, WAQAAR
Entity Type:Individual
Prefix:
First Name:WAQAAR
Middle Name:
Last Name:SALIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13920 CAMBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-7376
Mailing Address - Country:US
Mailing Address - Phone:815-254-1107
Mailing Address - Fax:
Practice Address - Street 1:1900 OGDEN AVENUE
Practice Address - Street 2:SUITE 203
Practice Address - City:OGDEN
Practice Address - State:IL
Practice Address - Zip Code:60504
Practice Address - Country:US
Practice Address - Phone:630-978-6218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070-009900OtherLICENSE #