Provider Demographics
NPI:1295940724
Name:KHAWAJA, OSMAAN ABBAS (MD)
Entity type:Individual
Prefix:DR
First Name:OSMAAN
Middle Name:ABBAS
Last Name:KHAWAJA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:215 E 1ST ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021-3166
Mailing Address - Country:US
Mailing Address - Phone:815-285-5842
Mailing Address - Fax:815-285-5845
Practice Address - Street 1:215 E 1ST ST
Practice Address - Street 2:SUITE 105
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-3166
Practice Address - Country:US
Practice Address - Phone:815-285-5842
Practice Address - Fax:815-285-5845
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-08-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL208600000X, 2086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery