Organization
THINFAST MD ROCKFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMEEL AHAMED (OFFICE BILLER)
(847) 227-0293
Entity
Organization
Contact information
Practice address
461 N MULFORD RD STE 9, ROCKFORD, IL 61107-5165
(815) 229-1899
Mailing address
461 N MULFORD RD, STE 9, ROCKFORD, IL 61107-5190
(815) 229-1899
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
209007392
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-126253
—
IL
Enumeration date
05/25/2012
Last updated
06/06/2014
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