Provider Demographics
NPI:1548849664
Name:KHALEEL, TAHSEEN ANJUM (MD)
Entity type:Individual
Prefix:
First Name:TAHSEEN
Middle Name:ANJUM
Last Name:KHALEEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 S HIGHLAND AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-7129
Mailing Address - Country:US
Mailing Address - Phone:630-916-1400
Mailing Address - Fax:
Practice Address - Street 1:2500 S HIGHLAND AVE STE 350
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-7129
Practice Address - Country:US
Practice Address - Phone:630-916-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125078368390200000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program