Individual
DR. MOHAMED FAROOQ AHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 N 9TH ST, SUITE 4W16, SPRINGFIELD, IL 62702-5303
(217) 545-8000
(217) 757-6844
Mailing address
415 N 9TH ST, PO BOX 19676, SPRINGFIELD, IL 62794-9676
(217) 545-8000
(217) 757-6844
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
036-138807
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036138807
—
IL
Enumeration date
04/19/2012
Last updated
12/11/2015
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