Individual
KHANSA AHMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
4600 N CLARENDON AVE APT 508, CHICAGO, IL 60640-5749
(832) 477-6443
Mailing address
960 MASSACHUSETTS AVE, FL 2, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1019208
MA
207RC0000X
Cardiovascular Disease Physician
Primary
1019208
MA
207RI0011X
Interventional Cardiology Physician
1019208
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110208536A
—
MA
Enumeration date
03/31/2015
Last updated
04/10/2026
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