Organization
CHANDRA DIAGNOSTIC CARDIOLOGY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AZAZUDDIN AHMED MD (OWNER)
(630) 915-9231
Entity
Organization
Contact information
Practice address
3330 W 177TH ST STE 3E, HAZEL CREST, IL 60429-2196
(708) 798-4500
(708) 798-4586
Mailing address
10718 S EWING AVE, CHICAGO, IL 60617-6605
(773) 731-5456
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036092076
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036092076
—
IL
01
—
CJ8102
MEDICARE RAILROAD
IL
Enumeration date
07/26/2006
Last updated
05/01/2023
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