Individual
DR. AHMED TAREK ELRAKHAWY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1818 E WINDSOR RD, URBANA, IL 61802-9566
(217) 255-9646
(217) 326-1777
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036107788
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036107788
—
IL
01
—
110244768
RAILROAD MEDICARE
IL
01
—
510814
HEALTHLINK
IL
Enumeration date
08/16/2005
Last updated
01/29/2021
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