Organization
A & D MEDICAL CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAWED EHSAN M D (OWNER)
(847) 742-0165
Entity
Organization
Contact information
Practice address
64 N ALFRED AVE, SUITE B, ELGIN, IL 60123-5284
(847) 742-0165
(847) 742-0190
Mailing address
64 N ALFRED AVE, SUITE B, ELGIN, IL 60123-5284
(847) 742-0165
(847) 742-0190
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
IL
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04532181
BCBS
IL
01
—
209598
MEDICARE ID
—
01
—
P00090413
RAILROAD
—
Enumeration date
10/13/2006
Last updated
04/15/2008
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