Individual
RIZWAN S AHMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
104 W 6TH ST, SUITE 204, STREATOR, IL 61364-2899
(815) 673-5533
(815) 673-2554
Mailing address
104 W 6TH ST, SUITE 204, STREATOR, IL 61364-2899
(815) 673-5533
(815) 673-2554
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036124179
IL
208C00000X
Colon & Rectal Surgery Physician
036124179
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD28493
STATE LICENSE
OR
Enumeration date
08/21/2008
Last updated
08/22/2011
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