Individual
REHAN AHMED NIZAMUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2650 RIDGE AVE, SUITE 1304, EVANSTON, IL 60201-1718
(224) 639-6624
Mailing address
2650 RIDGE AVE., DEPT. OF RADIOLOGY, EVANSTON, IL 60201-1057
(847) 570-2477
(847) 570-2942
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125068937
IL
2085R0202X
Diagnostic Radiology Physician
Primary
036156032
IL
2085R0202X
Diagnostic Radiology Physician
2018014985
MO
Other
Enumeration date
05/02/2016
Last updated
04/29/2022
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