Provider Demographics
NPI:1558522730
Name:JANJUA, KASHIF A (MD)
Entity Type:Individual
Prefix:DR
First Name:KASHIF
Middle Name:A
Last Name:JANJUA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N WINFIELD RD STE 202
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1379
Mailing Address - Country:US
Mailing Address - Phone:630-933-4700
Mailing Address - Fax:630-933-4427
Practice Address - Street 1:25 N WINFIELD RD STE 202
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1379
Practice Address - Country:US
Practice Address - Phone:630-933-4700
Practice Address - Fax:630-933-4427
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08936700207R00000X
IL036141639207R00000X, 208M00000X
MIEMC0003225207R00000X
IN01074952A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0274429Medicaid
MIEMC0003225OtherSTATE OF MICHIGAN