Individual
DR. FAIYAZ AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
934 WEST AUSTIN DRIVE, PEORIA, IL 61614
(309) 693-0030
Mailing address
934 WEST AUSTIN DRIVE, PEORIA, IL 61614
(309) 693-0030
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036047431
IL
208D00000X
General Practice Physician
Primary
036047431
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036047431
—
IL
Enumeration date
05/04/2007
Last updated
07/26/2013
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