Organization
AHMED MEDICAL ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHALID F AHMED M.D. (SERCRETARY)
17735817300
Entity
Organization
Contact information
Practice address
6449 S PULASKI RD, CHICAGO, IL 60629-5148
(773) 581-7300
(773) 581-7260
Mailing address
6449 S PULASKI RD, CHICAGO, IL 60629-5148
(773) 581-7300
(773) 581-7260
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036055369
IL
207Q00000X
Family Medicine Physician
Primary
036051565
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051565
—
IL
01
—
21609255
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/27/2010
Last updated
10/12/2010
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