Wagih Nessim, MD
Individual provider Active NPI Internal Medicine Physician · Hillside, IL
NPI 1295750883 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1295750883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 3647031 (IL)
- Practice address
- 4413 Roosevelt Rd
#101
Hillside, IL 60162-2074 - Phone
- (708) 449-2648
- Fax
- (708) 449-2683
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3647031 | IL | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 3647031 | IL | Yes |
Addresses
Primary practice location
4413 Roosevelt Rd
#101
Hillside, IL 60162-2074
Mailing address
4413 Roosevelt Rd
#101
Hillside, IL 60162-2074
Phone (708) 449-2648
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036047031 | Medicaid | IL |
Other providers in Hillside, IL
- MH Health Care Services, PC
- Annie Mo
- Felix Rodrigo Monroy
- Namm Partners, Inc.
- Magdoleen Nessim
- New Standard Medical Supply, Inc.
- Kelly Anne Newhouse
- Minh Nguyen
- Tuyen Nguyen
- Nadege Muyo Njigeh
All providers in Hillside, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.