# ROSELLE PHYSICAL MEDICINE GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851776439
- **Authorized official:** DR. TARIQ AHMED DC (PRESIDENT)
- **Authorized official phone:** (630) 295-8851

## Contact information

- **Practice address:** 50 E IRVING PARK RD, ROSELLE, IL 60172-2050
- **Practice address phone:** (630) 295-8851
- **Practice address fax:** (630) 295-8852
- **Mailing address:** 50 E IRVING PARK RD, ROSELLE, IL 60172-2050
- **Mailing address phone:** (630) 295-8851
- **Mailing address fax:** (630) 295-8852

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | Yes |
| 364SA2200X | Adult Health Clinical Nurse Specialist | — | NULL | — |
| 364SA2200X | Adult Health Clinical Nurse Specialist | — | — | — |

## Other

- **Enumeration date:** 07/24/2015
- **Last updated:** 07/24/2015