Individual
SHAKEEL AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
207RG0100X
Gastroenterology Physician
Primary
036107831
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008232127
BLUE CROSS BLUE SHIELD IL
IL
05
—
036107831
—
IL
Enumeration date
07/17/2006
Last updated
11/15/2011
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