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Organization
T AHMAD MD SC
Active
Organization
T AHMAD MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANVEER AHMAD M.D. (OWNER)
(815) 703-9124
Entity
Organization
Contact information
Practice address
21807 W GRANT HWY, MARENGO, IL 60152-2944
(815) 568-1074
(815) 568-0134
Mailing address
PO BOX 1527, WOODSTOCK, IL 60098-1527
(847) 338-1477
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036072630
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036072630
—
IL
Enumeration date
05/18/2011
Last updated
12/14/2011
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