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Organization
MISBAH UDDIN AHMED MD SC
Active
Organization
MISBAH UDDIN AHMED MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MISBAH UDDIN AHMED MD (OWNER)
(815) 935-2525
Entity
Organization
Contact information
Practice address
555 W COURT ST, STE 200, KANKAKEE, IL 60901-3664
(815) 935-2525
(815) 935-1010
Mailing address
555 W COURT ST, STE 200, KANKAKEE, IL 60901-3674
(815) 935-2525
(815) 935-1010
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098582
—
IL
05
—
036205509
—
IL
01
—
110197518
RAILROAD MEDICARE
IL
01
—
1306854203
INDIVIDUAL NPI
IL
01
—
1922117811
INDIVIDUAL NPI
IL
01
—
930068554
RAILROAD MEDICARE
IL
01
—
CG4030
RAILROAD MEDICARE GROUP
IL
Enumeration date
07/20/2007
Last updated
07/08/2008
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