Individual
AHMED ALI TARIQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1201 PINE ST, ELDORADO, IL 62930-1634
(618) 273-3361
Mailing address
75 REMIT DR, STE 1122, CHICAGO, IL 60675-1122
(866) 916-5259
(231) 922-4030
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036110691
IL
Other
Enumeration date
12/27/2005
Last updated
02/08/2017
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