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Organization
SOUTH SUBURBAN MEDICAL CLINIC LLC
Active
Organization
SOUTH SUBURBAN MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NADEEM AHMAD MD (OWNER)
(708) 748-9952
Entity
Organization
Contact information
Practice address
3800 W 203RD ST, SUITE 201, OLYMPIA FIELDS, IL 60461-1184
(708) 748-9952
(708) 748-9924
Mailing address
3800 W 203RD ST, SUITE 201, OLYMPIA FIELDS, IL 60461-1184
(708) 748-9952
(708) 748-9924
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036103449
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036103449
—
IL
01
—
1700868023
INDIVIDUAL NPI
IL
Enumeration date
09/30/2008
Last updated
01/11/2010
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