Organization
JESSE BROWN VETERANS ADMINISTRATION HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARIDA AHMED M.D. (STAFF RADIOLOGIST)
(312) 569-6123
Entity
Organization
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-6123
(312) 569-8102
Mailing address
950 N CLARK ST, UNIT K.,, CHICAGO, IL 60610-8701
(312) 280-1840
(312) 280-4546
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
036066117
IL
Other
Enumeration date
10/09/2005
Last updated
07/21/2008
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