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Organization

CENTER FOR GASTROINTESTINAL HEALTH, SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHAKEEL AHMED MD (PRESIDENT)
(618) 239-0678
Entity
Organization

Contact information

Practice address
5023 N ILLINOIS ST, FAIRVIEW HEIGHTS, IL 62208-3453
(618) 239-0678
(618) 235-0471
Mailing address
5023 N ILLINOIS ST, FAIRVIEW HEIGHTS, IL 62208-3453
(618) 239-0678
(618) 235-0471

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036072761
IL
207RG0100X
Gastroenterology Physician
Primary
036107831
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DC1913
RAILROAD MEDICARE
IL
Enumeration date
07/20/2007
Last updated
10/09/2014
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