Provider Demographics
NPI:1568993657
Name:SIRAJ, KHAJA M (DO)
Entity type:Individual
Prefix:
First Name:KHAJA
Middle Name:M
Last Name:SIRAJ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 HIGHLAND AVENUE
Mailing Address - Street 2:SUITE AIP
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1500
Mailing Address - Country:US
Mailing Address - Phone:708-283-5500
Mailing Address - Fax:
Practice Address - Street 1:3815 HIGHLAND AVENUE
Practice Address - Street 2:SUITE AIP
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1500
Practice Address - Country:US
Practice Address - Phone:708-283-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.070904207R00000X
IL036150771207R00000X, 208M00000X
IL036.150771207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist